European Radiology

, Volume 24, Issue 3, pp 619–629 | Cite as

Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn’s disease assessment with histopathology of surgical specimens

  • Jeroen A. W. TielbeekEmail author
  • Manon L. W. Ziech
  • Zhang Li
  • Cristina Lavini
  • Shandra Bipat
  • Willem A. Bemelman
  • Joris J. T. H. Roelofs
  • Cyriel Y. Ponsioen
  • Frans M. Vos
  • Jaap Stoker



To prospectively compare conventional MRI sequences, dynamic contrast enhanced (DCE) MRI and diffusion weighted imaging (DWI) with histopathology of surgical specimens in Crohn’s disease.


3-T MR enterography was performed in consecutive Crohn’s disease patients scheduled for surgery within 4 weeks. One to four sections of interest per patient were chosen for analysis. Evaluated parameters included mural thickness, T1 ratio, T2 ratio; on DCE-MRI maximum enhancement (ME), initial slope of increase (ISI), time-to-peak (TTP); and on DWI apparent diffusion coefficient (ADC). These were compared with location-matched histopathological grading of inflammation (AIS) and fibrosis (FS) using Spearman correlation, Kruskal–Wallis and Chi-squared tests.


Twenty patients (mean age 38 years, 12 female) were included and 50 sections (35 terminal ileum, 11 ascending colon, 2 transverse colon, 2 descending colon) were matched to AIS and FS. Mural thickness, T1 ratio, T2 ratio, ME and ISI correlated significantly with AIS, with moderate correlation (r = 0.634, 0.392, 0.485, 0.509, 0.525, respectively; all P < 0.05). Mural thickness, T1 ratio, T2 ratio, ME, ISI and ADC correlated significantly with FS (all P < 0.05).


Quantitative parameters from conventional, DCE-MRI and DWI sequences correlate with histopathological scores of surgical specimens. DCE-MRI and DWI parameters provide additional information.

Key points

Conventional MR enterography can be used to assess Crohns disease activity.

Several MRI parameters correlate with inflammation and fibrosis scores from histopathology.

Dynamic contrast enhanced imaging and diffusion weighted imaging give additional information.

Quantitative MRI parameters can be used as biomarkers to evaluate Crohns disease activity.


Magnetic resonance imaging Magnetic resonance enterography Contrast Apparent diffusion coefficient Crohn’s disease 



Apparent diffusion coefficient


Crohn’s disease activity index


C-reactive protein


Dynamic contrast enhanced


Diffusion weighted imaging


Initial slope of increase


Maximum enhancement


Region of interest





A research grant was given by NutsOhra Foundation (Amsterdam, the Netherlands). The NutsOhra Foundation was not involved in designing and conducting this study, did not have access to the data, and was not involved in data analysis or preparation of this manuscript.


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Jeroen A. W. Tielbeek
    • 1
    Email author
  • Manon L. W. Ziech
    • 1
  • Zhang Li
    • 2
  • Cristina Lavini
    • 1
  • Shandra Bipat
    • 1
  • Willem A. Bemelman
    • 3
  • Joris J. T. H. Roelofs
    • 4
  • Cyriel Y. Ponsioen
    • 5
  • Frans M. Vos
    • 1
    • 2
  • Jaap Stoker
    • 1
  1. 1.Academic Medical Center, Department of RadiologyUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Quantitative Imaging Group, Department of Imaging Science and TechnologyDelft University of TechnologyDelftThe Netherlands
  3. 3.Academic Medical Center, Department of SurgeryUniversity of AmsterdamAmsterdamThe Netherlands
  4. 4.Academic Medical Center, Department of PathologyUniversity of AmsterdamAmsterdamThe Netherlands
  5. 5.Academic Medical Center, Department of Gastroenterology and HepatologyUniversity of AmsterdamAmsterdamThe Netherlands

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