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European Radiology

, Volume 28, Issue 10, pp 4429–4437 | Cite as

Mesenteric lymph nodes in MR enterography: are they reliable followers of bowel in active Crohn’s disease?

  • Amir Reza Radmard
  • Rana Eftekhar Vaghefi
  • Seyed Ali Montazeri
  • Sara Naybandi Atashi
  • Amir Pejman Hashemi Taheri
  • Sepehr Haghighi
  • Aneseh Salehnia
  • Mehrdad Dadgostar
  • Reza Malekzadeh
Magnetic Resonance

Abstract

Objectives

To demonstrate magnetic resonance enterography (MRE) features of mesenteric lymph nodes (LN) in patients with Crohn’s disease (CD) and investigate whether they follow enhancement or apparent diffusion coefficient (ADC) parameters of bowel.

Methods

This study was approved by the institutional review board. A total of 788 MREs from patients with CD were retrospectively reviewed. Eighty-eight patients, aged 16-66 years, including 59 active cases, were enrolled based on inclusion criteria. In each MRE, two segments (normal and abnormal) and two LNs (regional and non-regional) were independently suggested, consensually chosen, and analyzed by two radiologists. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated to assess signal intensities (SI) at 30, 60 and 180 s after contrast administration, as well as slope of enhancement (SOE). Enhancement parameters and ADC values were compared.

Results

Regional LNs showed significantly higher SI30, SI60 and SI180 (CNR&SNR) and lower ADC values in active vs. inactive groups (all p<0.05) without significant difference in number or size. Strong correlations were demonstrated between abnormal segments and regional LNs in active group in terms of SI30, SI60, SI180, SOE0-30 and ADC values (r = 0.679 to 0.774, all p<0.001). SI180, SOE60-180 and ADC values were moderately correlated between abnormal segments and regional LNs in inactive group (r = 0.448 to 0.595, all p<0.05). In logistic regression analyses, SOE0-30 and ADC value of regional LNs independently predicted active CD.

Conclusion

Mesenteric LNs follow quantitative enhancement and diffusion parameters of bowel in active CD. SOE0-30 and ADC value of LN could predict disease activity.

Key Points

Mesenteric LNs may strongly follow enhancement pattern of bowel in active CD.

DWI parameters of LNs and bowel were strongly correlated in active CD.

SI180 was moderately correlated between bowel and LNs in inactive CD.

DWI parameters were moderately correlated between LNs and bowel in inactive CD.

SOE0-30 and ADC value of mesenteric LN could predict disease activity.

Keywords

Crohn’s disease Mesentery Lymph nodes Diffusion magnetic resonance imaging Contrast media 

Abbreviations

ADC

Apparent diffusion coefficient

CD

Crohn’s disease

CNR

Contrast-to-noise ratio

ESR

Erythrocyte sedimentation rate

LN

Lymph node

MRE

Magnetic resonance enterography

SAD

Short axis diameter

SI

Signal intensity

SNR

Signal-to-noise ratio

SOE

Slope of enhancement

Notes

Acknowledgements

We would like to thank the staff of our imaging center for their effort and contribution in patient care and helping us to diagnose and manage patients with Crohn’s disease.

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Reza Malekzadeh.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Informed consent was waived due to the retrospective nature of this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• cross sectional study

• performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Amir Reza Radmard
    • 1
  • Rana Eftekhar Vaghefi
    • 1
  • Seyed Ali Montazeri
    • 2
  • Sara Naybandi Atashi
    • 1
  • Amir Pejman Hashemi Taheri
    • 1
  • Sepehr Haghighi
    • 1
  • Aneseh Salehnia
    • 1
  • Mehrdad Dadgostar
    • 3
  • Reza Malekzadeh
    • 2
  1. 1.Department of Radiology, Shariati HospitalTehran University of Medical SciencesTehranIran
  2. 2.Digestive Diseases Research Center, Digestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
  3. 3.Department of Electrical Engineering, Central Tehran BranchIslamic Azad UniversityTehranIran

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