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Erschienen in: Abdominal Radiology 12/2017

01.12.2017

Increasing efficiency of MRE for diagnosis of Crohn’s disease activity through proper sequence selection: a practical approach for clinical trials

verfasst von: Jordi Rimola, Almudena Alvarez-Cofiño, Tamara Pérez-Jeldres, Sonia Rodríguez, Ignacio Alfaro, Ingrid Ordás, Elena Ricart, Julián Panés

Erschienen in: Abdominal Radiology | Ausgabe 12/2017

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Abstract

Purpose

To derive the best magnetic resonance enterography (MRE) approach for detecting activity and severe lesions in Crohn’s disease (CD) to use for selecting patients and measuring response to treatment in clinical trials.

Methods

We compared the accuracies of MRE (T2-weighted sequences, DWI (b = 800 s/mm2) sequences, combined T2-weighted and DWI sequences, combined T2-weighted or DWI sequences, and MaRIA score based on T2-weighted and contrast-enhanced T1-weighted sequences) versus ileocolonoscopy (SES-CD) performed within 1 month. Bowel segments were classified as inactive (SES-CD < 2), active (SES-CD ≥ 2), or active with severe lesions (ulcers seen at endoscopy). McNemar’s test was used to compare the accuracies of the different approaches against endoscopy.

Results

224 segments in 43 patients were analyzed. For detecting active disease, the combination of findings from T2 and DWI sequences results in the highest specific and accurate sequence combination. Combined T2-weighted and DWI sequences had similar sensitivity to those of MaRIA (P = 0.25) but lower specificity (P = 0.007) and accuracy (P = 0.0013) than MaRIA score. For detecting severe lesions, T2-weighted sequences alone had greater accuracy [similar to MaRIA score (P > 0.999)] than other noncontrast approaches.

Conclusions

T2-weighted sequences should be used as a first screening step, and followed by contrast-enhanced T1-weighted sequences only when abnormal findings are identified; adding DWI does not improve the accuracy of MRE.
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Metadaten
Titel
Increasing efficiency of MRE for diagnosis of Crohn’s disease activity through proper sequence selection: a practical approach for clinical trials
verfasst von
Jordi Rimola
Almudena Alvarez-Cofiño
Tamara Pérez-Jeldres
Sonia Rodríguez
Ignacio Alfaro
Ingrid Ordás
Elena Ricart
Julián Panés
Publikationsdatum
01.12.2017
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 12/2017
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-017-1203-7

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