Pediatric Radiology

, Volume 43, Issue 1, pp 103–114 | Cite as

Small-bowel MRI in children and young adults with Crohn disease: retrospective head-to-head comparison of contrast-enhanced and diffusion-weighted MRI

  • Henning Neubauer
  • Thomas Pabst
  • Anke Dick
  • Wolfram Machann
  • Laura Evangelista
  • Clemens Wirth
  • Herbert Köstler
  • Dietbert Hahn
  • Meinrad Beer
Original Article

Abstract

Background

Small-bowel MRI based on contrast-enhanced T1-weighted sequences has been challenged by diffusion-weighted imaging (DWI) for detection of inflammatory bowel lesions and complications in patients with Crohn disease.

Objective

To evaluate free-breathing DWI, as compared to contrast-enhanced MRI, in children, adolescents and young adults with Crohn disease.

Materials and methods

This retrospective study included 33 children and young adults with Crohn disease ages 17 ± 3 years (mean ± standard deviation) and 27 matched controls who underwent small-bowel MRI with contrast-enhanced T1-weighted sequences and DWI at 1.5 T. The detectability of Crohn manifestations was determined. Concurrent colonoscopy as reference was available in two-thirds of the children with Crohn disease.

Results

DWI and contrast-enhanced MRI correctly identified 32 and 31 patients, respectively. All 22 small-bowel lesions and all Crohn complications were detected. False-positive findings (two on DWI, one on contrast-enhanced MRI), compared to colonoscopy, were a result of large-bowel lumen collapse. Inflammatory wall thickening was comparable on DWI and contrast-enhanced MRI. DWI was superior to contrast-enhanced MRI for detection of lesions in 27% of the assessed bowel segments and equal to contrast-enhanced MRI in 71% of segments.

Conclusion

DWI facilitates fast, accurate and comprehensive workup in Crohn disease without the need for intravenous administration of contrast medium. Contrast-enhanced MRI is superior in terms of spatial resolution and multiplanar acquisition.

Keywords

Crohn disease Diffusion-weighted imaging Paediatric Contrast medium MRI 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Henning Neubauer
    • 1
  • Thomas Pabst
    • 2
  • Anke Dick
    • 3
  • Wolfram Machann
    • 2
  • Laura Evangelista
    • 1
  • Clemens Wirth
    • 1
  • Herbert Köstler
    • 2
  • Dietbert Hahn
    • 2
  • Meinrad Beer
    • 1
  1. 1.Institute of Radiology, Department of Paediatric RadiologyUniversity Hospital WuerzburgWuerzburgGermany
  2. 2.Institute of RadiologyUniversity Hospital WuerzburgWuerzburgGermany
  3. 3.Department of PaediatricsUniversity Hospital WuerzburgWuerzburgGermany

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