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Magnetization transfer ratio for the assessment of perianal fistula activity in Crohn's disease

  • Gastrointestinal
  • Published:
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Abstract

Objectives

Assessment of perianal fistulas is important to guide management of Crohn's disease (CD). Our objectives were to analyze the feasibility of magnetization transfer (MT) imaging to assess fistulas and to evaluate its contribution in assessing disease activity.

Methods

During 15 months, all patients referred for perianal fistulas in CD underwent 3T-MRI including diffusion, T2/T1-weighted gadolinium-enhanced sequences and MT sequences (one with an off-resonance saturation pulse of 800 and one with 1200 Hz). We collected Van Assche score, fistula activity signs by analyzing T2, diffusion and contrast enhancement. We calculated MT ratio (MTR) with a ROI in the largest fistula.

Results

Twenty-nine patients (mean 34.9 years, range 17-53) were included. Van Assche score was 11.7, range 4–21. In 22 patients, the fistula presented with a bright T2 and diffusion signal with contrast enhancement, and was characterized as active. Mean MTR was respectively 47.2 (range 12–68) and 34.3 (range 11–57) at 800 and 1200 Hz. MTR at 800 Hz was significantly lower in non-active (34, range 12–55) than in active fistulas (51, range 24–68) (p < 0.02).

Conclusions

MTR is feasible for the assessment of fistulas in CD and in the future could be used to help identify active and non-active fistulas.

Key Points

• MTR is feasible for the assessment of perianal fistulas in CD.

• MT allows quantitative imaging of perianal fistula activity in CD.

• MTR could be used to help identify active and non-active fistulas in CD.

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Abbreviations

CD:

Crohn’s disease

MT:

Magnetization transfer

MTR:

Magnetization transfer ratio

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Acknowledgments

The authors are grateful to Nikki Sabourin-Gibbs, Rouen University Hospital, for her help in editing the manuscript. The scientific guarantor of this publication is Celine Savoye-Collet. 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. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: diagnostic or prognostic study performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Rouen University Hospital-Charles Nicolle, 1 rue de Germont, F-76031, Rouen cedex, France

    C. Pinson, M. Dolores, Y. Cruypeninck, E. Koning, J. N. Dacher & C. Savoye-Collet

  2. Department of Gastroenterology, Rouen University Hospital-Charles Nicolle, 1 rue de Germont, F-76031, Rouen cedex, France

    G. Savoye

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  1. C. Pinson
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  2. M. Dolores
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  3. Y. Cruypeninck
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  4. E. Koning
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  5. J. N. Dacher
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  6. G. Savoye
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  7. C. Savoye-Collet
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Correspondence to C. Savoye-Collet.

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Pinson, C., Dolores, M., Cruypeninck, Y. et al. Magnetization transfer ratio for the assessment of perianal fistula activity in Crohn's disease. Eur Radiol 27, 80–87 (2017). https://doi.org/10.1007/s00330-016-4350-2

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  • DOI: https://doi.org/10.1007/s00330-016-4350-2

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