Influence of diffusion weighted imaging and contrast enhanced T1 sequences on the diagnostic accuracy of magnetic resonance enterography for Crohn's disease.

Autor: Bhatnagar G; Centre for Medical Imaging, University College London, Charles Bell House, 43-45 Foley Street W1W 7TS, UK., Mallett S; Centre for Medical Imaging, University College London, Charles Bell House, 43-45 Foley Street W1W 7TS, UK., Beable R; Department of Radiology, Portsmouth Hospitals NHS Trust, Portsmouth, UK., Greenhalgh R; Intestinal Imaging Centre, St Mark's Hospital, LNWUH NHS Trust, Harrow, UK., Ilangovan R; Intestinal Imaging Centre, St Mark's Hospital, LNWUH NHS Trust, Harrow, UK., Lambie H; Department of Radiology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds LS9 7TF, UK., Mainta E; Intestinal Imaging Centre, St Mark's Hospital, LNWUH NHS Trust, Harrow, UK., Patel U; Intestinal Imaging Centre, St Mark's Hospital, LNWUH NHS Trust, Harrow, UK., Porté F; Intestinal Imaging Centre, St Mark's Hospital, LNWUH NHS Trust, Harrow, UK., Sidhu H; Centre for Medical Imaging, University College London, Charles Bell House, 43-45 Foley Street W1W 7TS, UK., Gupta A; Intestinal Imaging Centre, St Mark's Hospital, LNWUH NHS Trust, Harrow, UK; Department of Surgery and Cancer, Imperial College London, Exhibition Rd, South Kensington, London SW7 2BX, UK., Higginson A; Department of Radiology, Portsmouth Hospitals NHS Trust, Portsmouth, UK., Slater A; Department of Radiology, Oxford University Hospitals NHS Trust, Oxford, UK., Tolan D; Department of Radiology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds LS9 7TF, UK., Zealley I; Department of Radiology, Ninewells Hospital, Dundee DD1 9SY, UK., Halligan S; Centre for Medical Imaging, University College London, Charles Bell House, 43-45 Foley Street W1W 7TS, UK., Taylor SA; Centre for Medical Imaging, University College London, Charles Bell House, 43-45 Foley Street W1W 7TS, UK. Electronic address: stuart.taylor@ucl.ac.uk.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2024 Jun; Vol. 175, pp. 111454. Date of Electronic Publication: 2024 Apr 05.
DOI: 10.1016/j.ejrad.2024.111454
Abstrakt: Objectives: To evaluate the additional diagnostic benefit of diffusion weighted imaging (DWI) and contrast enhanced (CE) images during MR enterography (MRE) of Crohn's disease.
Methods: Datasets from 73 patients (mean age 32; 40 male) (28 new-diagnosis, 45 relapsed) were read independently by two radiologists selected from a pool of 13. Radiologists interpreted datasets using three sequential sequence blocks: (1) T2 weighted and steady state free precession gradient echo (SSFP) images alone (T2^); (2) T2 weighted and SSFP images with DWI (T2 + DWI^) and; (3) T2 weighted images, SSFP, DWI and post-contrast enhanced (CE) T1 images (T2 + DWI + CE^), documenting presence, location, and activity of small bowel disease. For each sequence block, sensitivity and specificity (readers combined) was calculated against an outcome-based construct reference standard.
Results: 59/73 patients had small bowel disease. Per-patient sensitivity for disease detection was essentially identical (80 % [95 % CI 72, 86], 81 % [73,87], and 79 % [71,86] for T2^, T2 + DWI^and T2 + DWI + CE^respectively). Specificity was identical (82 % [64 to 92]). Per patient sensitivity for disease extent was 56 % (47,65), 56 % (47,65) and 52 % (43 to 61) respectively, and specificity was 82 % (64 to 92) for all blocks. Sensitivity for active disease was 97 % (90,99), 97 % (90,99) and 98 % (92,99), and specificity was also comparable between all sequence combination reads. Results were consistent across segments and newly diagnosed/relapse patients.
Conclusion: There is no additional diagnostic benefit of adding either DWI or CE to T2 FSE and SSFP sequences for evaluating small bowel Crohn's disease, suggesting MRE protocols can be simplified safely.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. STaylor has shares in Motilent, research support from Takeda and research consultant to Aztrazeneca.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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