Assessment of activity of Crohn disease by diffusion-weighted magnetic resonance imaging

Xue Hua Li, Can Hui Sun, Ren Mao, Zhong Wei Zhang, Xiao Song Jiang, Margaret H. Pui, Min Hu Chen, Zi Ping Li

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

To assess the diagnostic efficacy of diffusion-weighted MR imaging (DWI) for evaluating inflammatory activity in patients with Crohn's disease (CD). A total of 47 CD patients underwent MR enterography (MRE) and DWI using 3 b values of 50, 400, and 800 s/mm.2 Apparent diffusion coefficients (ADCs) of inflamed and normal bowel wall were calculated. The conventional MRE findings and DWI signal intensities were qualitatively scored from 0 to 3. The correlation between Crohn disease activity index (CDAI) and both ADCs and magnetic resonance imaging scores was analyzed. Receiver-operating characteristic curve analysis was used to determine the diagnostic accuracy of CD activity. Of the 47 patients, 25 were active CD (CDAI≥150) and 22 were inactive (CDAI<150). Diffusion-weightedMR imaging and MRE+DWI scores of active CD were significantly higher than that of inactive CD (both P<0.001). Apparent diffusion coefficients in inflamed segments of active CD were lower than that of inactive CD (P<0.001).The DWI scores (r=0.74, P<0.001), ADCs (r=-0.71, P<0.001), MRE scores (r=0.54, P<0.001), and MRE+DWI scores (r=0.66, P<0.001) were all correlated with CDAI. The areas under the receiver-operating characteristics curves for ADCs, DWI scores, MRE scores, and MRE+DWI scores ranged from 0.83 to 0.98. The threshold ADC value of 1.17×10-3mm2/s allowed differentiation of active from inactive CD with 100% sensitivity and 88% specificity. Diffusion-weighted MR imaging and ADC correlated with CD activity, and had excellent diagnostic accuracy for differentiating active from inactive CD.

Original languageEnglish
Article numbere1819
JournalMedicine (United States)
Volume94
Issue number43
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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