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Comparison Between 1.5 and 3.0 Tesla Magnetic Resonance Enterography for the Assessment of Disease Activity and Complications in Ileo-Colonic Crohn’s Disease

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Abstract

Background

Magnetic resonance imaging (MRI) can assess disease activity and severity in Crohn’s disease (CD). Three-Tesla magnetic resonance (3T) increases signal-to-noise ratio (SNR) and reduces time of image acquisition (IAT). Whether 3T increases the accuracy of MRI in CD compared to 1.5T is unknown.

Aim

We aimed to compare prospectively the accuracy of 3 and 1.5T in ileo-colonic CD patients.

Methods

Twenty-six patients with ileo-colonic CD underwent 1.5 and 3T MR enterography at the same time. Ileocolonoscopy was the reference standard for luminal disease. Sensitivity, specificity and accuracy of MRI in evaluating six signs of active and complicated disease (localization, thickening, enhancement, strictures, entero-enteric fistulas, and ulcers) were calculated for both techniques.

Results

Three-Tesla resulted as sensitive, specific, and accurate as 1.5T in detecting disease location (accuracy 0.93 vs. 0.86), bowel wall thickening and enhancement (accuracy 0.92 vs. 0.80 for both parameters), strictures (accuracy 0.90 vs. 0.80) and entero-enteric fistulas (accuracy 0.92 vs. 0.92). 3T was superior to 1.5T in detecting ulcers (0.76 vs. 0.42, P < 0.05). SNR resulted higher in 3T, and IAT resulted shorter than 1.5.

Conclusions

We found that 3T is equally accurate as 1.5T in evaluating ileo-colonic CD. Because of superiority in detecting mucosal ulcers, 3T should be preferred in patients with ileo-colonic CD.

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References

  1. Fiorino G, Bonifacio C, Peyrin-Biroulet L, et al. Prospective comparison of computed tomography enterography and magnetic resonance enterography for assessment of disease activity and complications in ileocolonic Crohn’s disease. Inflamm Bowel Dis. 2011;17:1073–1080.

    Article  PubMed  CAS  Google Scholar 

  2. Rimola J, Rodriguez S, Garcia-Bosch O, et al. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn’s disease. Gut. 2009;58:1113–1120.

    Article  PubMed  CAS  Google Scholar 

  3. Horsthuis K, Bipat S, Bennink RJ, Stoker J. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology. 2008;247:64–79.

    Article  PubMed  Google Scholar 

  4. Panes J, Bouzas R, Chaparro M, et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Aliment Pharmacol Ther. 2011;34:125–145.

    Article  PubMed  CAS  Google Scholar 

  5. Kroeker KI, Lam S, Birchall I, Fedorak RN. Patients with IBD are exposed to high levels of ionizing radiation through CT scan diagnostic imaging: a five-year study. J Clin Gastroenterol. 2011;45:34–39.

    Article  PubMed  Google Scholar 

  6. Fuchs Y, Markowitz J, Weinstein T, Kohn N, Choi-Rosen J, Levine J. Pediatric inflammatory bowel disease and imaging-related radiation: are we increasing the likelihood of malignancy? J Pediatr Gastroenterol Nutr. 2011;52:280–285.

    Article  PubMed  Google Scholar 

  7. Chang K, Kamel IR, Macura KJ, Bluemke DA. 3.0-T MR imaging of the abdomen: comparison with 1.5 T. Radiographics. 2008;28:1983–1998.

    Article  PubMed  Google Scholar 

  8. Rimola J, Rodriguez S, Garcia-Bosch O, et al. Role of 3.0-T MR colonography in the evaluation of inflammatory bowel disease. Radiographics. 2009;29:701–719.

    Article  PubMed  Google Scholar 

  9. van Gemert-Horsthuis K, Florie J, Hommes DW, et al. Feasibility of evaluating Crohn’s disease activity at 3.0 Tesla. J Magn Reson Imaging: JMRI. 2006;24:340–348.

    Article  PubMed  Google Scholar 

  10. Dagia C, Ditchfield M, Kean M, Catto-Smith A. Feasibility of 3-T MRI for the evaluation of Crohn disease in children. Pediatr Radiol. 2010;40:1615–1624.

    Article  PubMed  Google Scholar 

  11. Jensen MD, Ormstrup T, Vagn-Hansen C, Ostergaard L, Rafaelsen SR. Interobserver and intermodality agreement for detection of small bowel Crohn’s disease with MR enterography and CT enterography. Inflamm Bowel Dis. 2011;17:1081–1088.

    Article  PubMed  Google Scholar 

  12. Best WR, Becktel JM, Singleton JW, Kern F Jr. Development of a Crohn’s disease activity index. National Cooperative Crohn’s Disease Study. Gastroenterology. 1976;70:439–444.

    PubMed  CAS  Google Scholar 

  13. Mary JY, Modigliani R. Development and validation of an endoscopic index of the severity for Crohn’s disease: a prospective multicentre study. Groupe d’Etudes Therapeutiques des Affections Inflammatoires du Tube Digestif (GETAID). Gut. 1989;30:983–989.

    Article  PubMed  CAS  Google Scholar 

  14. Aime S, Caravan P. Biodistribution of gadolinium-based contrast agents, including gadolinium deposition. J Magn Reson Imaging: JMRI. 2009;30:1259–1267.

    Article  PubMed  Google Scholar 

  15. Adamek HE, Schantzen W, Rinas U, Goyen M, Ajaj W, Esser C. Ultra-high-field magnetic resonance enterography in the diagnosis of ileitis (Neo-) terminalis: a prospective study. J Clin Gastroenterol. 2012;46:311–316.

    Article  PubMed  Google Scholar 

  16. Cosnes J, Gower-Rousseau C, Seksik P, Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology. 2011;140:1785–1794.

    Article  PubMed  Google Scholar 

  17. Van Assche G, Dignass A, Panes J, et al. The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. J Crohns Colitis. 2010;4:7–27.

    Article  PubMed  Google Scholar 

  18. Thia KT, Sandborn WJ, Harmsen WS, Zinsmeister AR, Loftus EV Jr. Risk factors associated with progression to intestinal complications of Crohn’s disease in a population-based cohort. Gastroenterology. 2010;139:1147–1155.

    Article  PubMed  Google Scholar 

  19. Albert JG, Martiny F, Krummenerl A, et al. Diagnosis of small bowel Crohn’s disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut. 2005;54:1721–1727.

    Article  PubMed  CAS  Google Scholar 

  20. Pilleul F, Godefroy C, Yzebe-Beziat D, Dugougeat-Pilleul F, Lachaux A, Valette PJ. Magnetic resonance imaging in Crohn’s disease. Gastroenterol Clin Biol. 2005;29:803–808.

    Article  PubMed  Google Scholar 

  21. Borthne AS, Abdelnoor M, Rugtveit J, Perminow G, Reiseter T, Klow NE. Bowel magnetic resonance imaging of pediatric patients with oral mannitol MRI compared to endoscopy and intestinal ultrasound. Eur Radiol. 2006;16:207–214.

    Article  PubMed  Google Scholar 

  22. Horsthuis K, de Ridder L, Smets AM, et al. Magnetic resonance enterography for suspected inflammatory bowel disease in a pediatric population. J Pediatr Gastroenterol Nutr. 2010;51:603–609.

    Article  PubMed  Google Scholar 

  23. Low RN, Francis IR, Politoske D, Bennett M. Crohn’s disease evaluation: comparison of contrast-enhanced MR imaging and single-phase helical CT scanning. J Magn Reson Imaging: JMRI. 2000;11:127–135.

    Article  PubMed  CAS  Google Scholar 

  24. Pascu M, Roznowski AB, Muller HP, Adler A, Wiedenmann B, Dignass AU. Clinical relevance of transabdominal ultrasonography and magnetic resonance imaging in patients with inflammatory bowel disease of the terminal ileum and large bowel. Inflamm Bowel Dis. 2004;10:373–382.

    Article  PubMed  CAS  Google Scholar 

  25. Tillack C, Seiderer J, Brand S, et al. Correlation of magnetic resonance enteroclysis (MRE) and wireless capsule endoscopy (CE) in the diagnosis of small bowel lesions in Crohn’s disease. Inflamm Bowel Dis. 2008;14:1219–1228.

    Article  PubMed  Google Scholar 

  26. Koh DM, Miao Y, Chinn RJ, et al. MR imaging evaluation of the activity of Crohn’s disease. AJR Am J Roentgenol. 2001;177:1325–1332.

    Article  PubMed  CAS  Google Scholar 

  27. Miao YM, Koh DM, Amin Z, et al. Ultrasound and magnetic resonance imaging assessment of active bowel segments in Crohn’s disease. Clin Radiol. 2002;57:913–918.

    Article  PubMed  CAS  Google Scholar 

  28. Neurath MF, Vehling D, Schunk K, et al. Noninvasive assessment of Crohn’s disease activity: a comparison of 18F-fluorodeoxyglucose positron emission tomography, hydromagnetic resonance imaging, and granulocyte scintigraphy with labelled antibodies. Am J Gastroenterol. 2002;97:1978–1985.

    Article  PubMed  CAS  Google Scholar 

  29. Ochsenkuhn T, Herrmann K, Schoenberg SO, Reiser MF, Goke B, Sackmann M. Crohn disease of the small bowel proximal to the terminal ileum: detection by MR-enteroclysis. Scand J Gastroenterol. 2004;39:953–960.

    Article  PubMed  CAS  Google Scholar 

  30. Schreyer AG, Rath HC, Kikinis R, et al. Comparison of magnetic resonance imaging colonography with conventional colonoscopy for the assessment of intestinal inflammation in patients with inflammatory bowel disease: a feasibility study. Gut. 2005;54:250–256.

    Article  PubMed  CAS  Google Scholar 

  31. Florie J, Horsthuis K, Hommes DW, et al. Magnetic resonance imaging compared with ileocolonoscopy in evaluating disease severity in Crohn’s disease. Clin Gastroenterol Hepatol. 2005;3:1221–1228.

    Article  PubMed  Google Scholar 

  32. Siddiki HA, Fidler JL, Fletcher JG, et al. Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn’s disease. AJR Am J Roentgenol. 2009;193:113–121.

    Article  PubMed  Google Scholar 

  33. Oussalah A, Laurent V, Bruot O, et al. Diffusion-weighted magnetic resonance without bowel preparation for detecting colonic inflammation in inflammatory bowel disease. Gut. 2010;59:1056–1065.

    Article  PubMed  Google Scholar 

  34. Hyun SB, Kitazume Y, Nagahori M, et al. Magnetic resonance enterocolonography is useful for simultaneous evaluation of small and large intestinal lesions in Crohn’s disease. Inflamm Bowel Dis. 2011;17:1063–1072.

    Article  PubMed  Google Scholar 

  35. Rimola J, Ordas I, Rodriguez S, et al. Magnetic resonance imaging for evaluation of Crohn’s disease: validation of parameters of severity and quantitative index of activity. Inflamm Bowel Dis. 2011;17:1759–1768.

    Article  PubMed  Google Scholar 

  36. Magnano G, Granata C, Barabino A, et al. Polyethylene glycol and contrast-enhanced MRI of Crohn’s disease in children: preliminary experience. Pediatr Radiol. 2003;33:385–391.

    PubMed  Google Scholar 

  37. Maccioni F, Bruni A, Viscido A, et al. MR imaging in patients with Crohn disease: value of T2- versus T1-weighted gadolinium-enhanced MR sequences with use of an oral superparamagnetic contrast agent. Radiology. 2006;238:517–530.

    Article  PubMed  Google Scholar 

  38. Negaard A, Paulsen V, Sandvik L, et al. A prospective randomized comparison between two MRI studies of the small bowel in Crohn’s disease, the oral contrast method and MR enteroclysis. Eur Radiol. 2007;17:2294–2301.

    Article  PubMed  Google Scholar 

  39. Martinez MJ, Ripolles T, Paredes JM, Blanc E, Marti-Bonmati L. Assessment of the extension and the inflammatory activity in Crohn’s disease: comparison of ultrasound and MRI. Abdom Imaging. 2009;34:141–148.

    Article  PubMed  Google Scholar 

  40. Lee SS, Kim AY, Yang SK, et al. Crohn disease of the small bowel: comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. Radiology. 2009;251:751–761.

    Article  PubMed  Google Scholar 

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Acknowledgments

We gratefully thank Dr Francesco Minuti for the statistical support, and Carmen Correale for her kind English language revision.

Conflict of interest

None.

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Authors and Affiliations

  1. IBD Center, Gastroenterology, IRCCS Humanitas, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Gionata Fiorino, Alberto Malesci & Silvio Danese

  2. Radiology, IRCCS Humanitas, Rozzano, Milan, Italy

    Cristiana Bonifacio, Mauro Padrenostro, Federica Mrakic Sposta & Luca Balzarini

  3. 3rd Department of Surgery, IRCCS Humanitas, Rozzano, Milan, Italy

    Antonino Spinelli

  4. Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy-Brabois, Université de Lorraine, Vandoeuvre-lès-Nancy, France

    Laurent Peyrin-Biroulet

Authors
  1. Gionata Fiorino
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Corresponding author

Correspondence to Silvio Danese.

Additional information

Gionata Fiorino and Cristiana Bonifacio equally contributed to this study.

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Fiorino, G., Bonifacio, C., Padrenostro, M. et al. Comparison Between 1.5 and 3.0 Tesla Magnetic Resonance Enterography for the Assessment of Disease Activity and Complications in Ileo-Colonic Crohn’s Disease. Dig Dis Sci 58, 3246–3255 (2013). https://doi.org/10.1007/s10620-013-2781-z

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  • DOI: https://doi.org/10.1007/s10620-013-2781-z

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