Celine Dubron, Presenter: Nothing to Disclose

Elisa Amzallag-Bellenger MD, Abstract Co-Author: Nothing to Disclose

Alain Duhamel, Abstract Co-Author: Nothing to Disclose

DOMINIQUE TURCK, Abstract Co-Author: Nothing to Disclose

Nathalie Boutry, Abstract Co-Author: Nothing to Disclose

Fred E. Avni MD, PhD, Abstract Co-Author: Nothing to Disclose

Prospective evaluation of the performances of DWI for the detection of active lesions on MR-enterography in children with IBD.

Sixty five children (mean age 12.9 years (3-18 years), median age 14 years) with suspected or known IBD were examined by MR-enterography (1.5 Tesla magnets Philips – Eindhoven and GE – Milwaukee). Preparation included pre-examination ingestion of a mixture of Mannitol and water. T2 weighted, T1 after Gadolinium injection and diffusion weighted sequences were obtained. All images were reviewed on a PACS system by two radiologists, each blinded to the clinical data and to the conclusion of the second reviewer. The digestive tract was divided into 7 segments. The 2 radiologists were asked to analyze the images obtained and to report on the presence of active lesions defined as bowel thickening observed on T2 sequences associated with contrast enhancement. The radiologists analyzed successively and independently the images obtained by combining T2 and DWI on one site, T2 and T1 + Gadolinium on the other. The latter was considered as the gold-standard. Whenever no agreement was observed, analysis with consensus was obtained. Inter-observers agreement and sensitivity, specificity, PPV and NPV were calculated.

The couple « T2 + diffusion » detected 64 lesions in 42 patients whereas the couple “T2 + T1 with Gadolinium” detected 58 lesions in 36 patients. The inter-observer agreement was excellent with a Kappa coefficient of 0.84. Sensitivity, specificity, PPV and NPV for the couple “T2+DWI” for the detection of active lesions of IBD were respectively 100 %, 96 %, 79 % and 100 %. The accuracy between the two techniques reached 97%, with Kappa coefficient of 0.86. Seven supplementary lesions were detected by DWI and not by T1+gadolinium. 5/7 had a endoscopic or histologic study confirming active lesions.

Associated with T2 weighted sequence, DWI have equivalent or probably better performances than T1+gadolinium.

Its use would allow to perform shorter examination and obviate the need for gadolinium injection.

Dubron, C, Amzallag-Bellenger, E, Duhamel, A, TURCK, D, Boutry, N, Avni, F, Performance of Diffusion Weighted Sequences in Pediatric Patients with Inflammatory Bowel Diseases (IBD) Evaluated by MR-enterography.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005947.html