Abstract
Objectives
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.
Methods
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.
Results
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).
Conclusions
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 Crohn’s 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 Crohn’s disease activity.
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Abbreviations
- ADC:
-
Apparent diffusion coefficient
- CDAI:
-
Crohn’s disease activity index
- CRP:
-
C-reactive protein
- DCE:
-
Dynamic contrast enhanced
- DWI:
-
Diffusion weighted imaging
- ISI:
-
Initial slope of increase
- ME:
-
Maximum enhancement
- ROI:
-
Region of interest
- TTP:
-
Time-to-peak
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Acknowledgments
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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Tielbeek, J.A.W., Ziech, M.L.W., Li, Z. et al. Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn’s disease assessment with histopathology of surgical specimens. Eur Radiol 24, 619–629 (2014). https://doi.org/10.1007/s00330-013-3015-7
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DOI: https://doi.org/10.1007/s00330-013-3015-7