Diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI for assessment of anal fistula activity
| Autor: | Damien Olivié, An Tang, Jean-Sébastien Billiard, Philippe Lefrançois, Guillaume Gilbert, Mathieu Zummo-Soucy, Juliette Garel, Emmanuel Visée, Perrine Manchec |
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| Rok vydání: | 2018 |
| Předmět: |
Male
lcsh:Medicine Contrast Media Crohn's Disease Pathology and Laboratory Medicine Logistic regression Diagnostic Radiology 030218 nuclear medicine & medical imaging 0302 clinical medicine Medicine and Health Sciences lcsh:Science Intravoxel incoherent motion Brain Mapping Multidisciplinary medicine.diagnostic_test Radiology and Imaging Middle Aged Magnetic Resonance Imaging Markov Chains Research Design Dynamic contrast-enhanced MRI Female 030211 gastroenterology & hepatology Monte Carlo Method Research Article Adult Anal fistula Imaging Techniques Brain Morphometry Immunology Neuroimaging Gastroenterology and Hepatology Anal and Rectal Disorders Research and Analysis Methods Autoimmune Diseases Motion Young Adult 03 medical and health sciences Signs and Symptoms Diagnostic Medicine Echo Planar Imaging medicine Humans Rectal Fistula Fistulas Retrospective Studies Receiver operating characteristic Diffusion Weighted Imaging business.industry lcsh:R Inflammatory Bowel Disease Quantitative Analysis Biology and Life Sciences Bayes Theorem Magnetic resonance imaging Image Enhancement medicine.disease Confidence interval Anal Fistula Abscesses Cross-Sectional Studies Diffusion Magnetic Resonance Imaging Logistic Models ROC Curve lcsh:Q Clinical Immunology Clinical Medicine business Nuclear medicine Neuroscience Diffusion MRI |
| Zdroj: | PLoS ONE PLoS ONE, Vol 13, Iss 1, p e0191822 (2018) |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0191822 |
| Popis: | Objective To evaluate intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) sequences for quantitative characterization of anal fistula activity. Methods This retrospective study was approved by the institutional review board. One hundred and two patients underwent MRI for clinical suspicion of anal fistula. Forty-three patients with demonstrable anal fistulas met the inclusion criteria. Quantitative analysis included measurement of DCE and IVIM parameters. The reference standard was clinical activity based on medical records. Statistical analyses included Bayesian analysis with Markov Chain Monte Carlo, multivariable logistic regression, and receiver operating characteristic analyses. Results Brevity of enhancement, defined as the time difference between the wash-in and wash-out, was longer in active than inactive fistulas (p = 0.02). Regression coefficients of multivariable logistic regression analysis revealed that brevity of enhancement increased and normalized perfusion area under curve decreased with presence of active fistulas (p = 0.03 and p = 0.04, respectively). By cross-validation, a logistic regression model that included quantitative perfusion parameters (DCE and IVIM) performed significantly better than IVIM only (p < 0.001). Area under the curves for distinguishing patients with active from those with inactive fistulas were 0.669 (95% confidence interval [CI]: 0.500, 0.838) for a model with IVIM only, 0.860 (95% CI: 0.742, 0.977) for a model with IVIM and brevity of enhancement, and 0.921 (95% CI: 0.846, 0.997) for a model with IVIM and all DCE parameters. Conclusion The inclusion of brevity of enhancement measured by DCE-MRI improved assessment of anal fistula activity over IVIM-DWI only. |
| Databáze: | OpenAIRE |
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