Jeroen Tielbeek MD, Presenter: Nothing to Disclose

Manon L. Ziech MD, Abstract Co-Author: Nothing to Disclose

Zhang Li, Abstract Co-Author: Nothing to Disclose

Cristina Lavini DPhil, Abstract Co-Author: Nothing to Disclose

Shandra Bipat MS, Abstract Co-Author: Nothing to Disclose

Frans M. Vos PhD, Abstract Co-Author: Nothing to Disclose

Jaap Stoker MD, PhD, Abstract Co-Author: Research Consultant, Robarts Clinical Trials

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

3T MR enterography was performed in 25 consecutive CD patients scheduled for surgery within 4 weeks. A total of one to four sections per patient were chosen for detailed image analysis. Evaluated features including mural thickness, T1 signal ratio and T2 signal ratio and on DCE-MRI maximum enhancement (ME), initial slope of increase (ISI) and time to peak (TTP) and on DWI apparent diffusion coefficient (ADC), were compared to location matched-histopathologic grading of acute inflammation score (AIS) and fibrostenosis score (FS) by Spearman correlation, Kruskal Wallis and Mann-Whitney test.

Twenty patients (mean age 38 years, range 21-73, 12 females) were included and 50 bowel locations (35 terminal ileum, 11 ascending colon, 2 transverse colon, 2 descending colon) were matched to AIS and FS. Median AIS was 3 and median FS 1. Mural thickness, T1 signal ratio, T2 signal ratio, ME and ISI correlated significantly to AIS (r = 0.634, 0.392, 0.485, 0.526, 0.514, respectively; all p<0.05). Mural thickness, T1 and T2 signal ratio differed significantly between the grades of FS (p<0.001, p=0.001, p=0.021, respectively). ME, ISI and ADC values differed significantly between the non-fibrotic sections and the fibrotic sections (p<0.001, p=0.001, p=0.023, respectively).

Quantitative parameters from conventional, DCE-MRI and DWI sequences correlate significantly to histopathologic scores of surgical specimens. DCE-MRI and DWI give comparable results but do not outperform conventional MRI parameters.

DCE- and DWI-MRI can be used for quantitative evaluation of Crohn's disease activity.

Tielbeek, J, Ziech, M, Li, Z, Lavini, C, Bipat, S, Vos, F, Stoker, J, Evaluation of Dynamic Contrast Enhanced and Diffusion Weighted Imaging for Quantitative Crohn’s Disease Assessment Based on Histopathologic Characterization.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13026580.html