Year 2019 / Volume 111 / Number 1
Original
Apparent diffusion coefficient and enhancement patterns in MR imaging as markers of severe or moderate ileum inflammation in Crohn’s disease

28-33

DOI: 10.17235/reed.2018.5691/2018

Riccardo Faletti, Davide Giuseppe Ribaldone, Marco Gatti, Chiara Perazzini, Mattia Robella, Francesca Angelino, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano, Paolo Fonio,

Abstract
Background and purpose: magnetic resonance enterography has been increasingly used for the diagnosis and follow-up of Crohn’s disease (CD). The purpose of the study was to compare the apparent diffusion coefficient (ADC) with wall enhancement for the differentiation of severe, moderate or no inflammation activity in the ileum. Methods: a prospective, blinded study was conducted of 46 CD patients with a clinical Crohn’s disease activity index (CDAI) ≥ 220 and a simple endoscopic score for Crohn’s disease (ES-CD) ≥ 7, which yielded 58 inflamed segments with CD. Twenty controls were also included. All segments were characterized by four ADC readings. The two different enhancement patterns observed in inflamed segments, transmural or mucosal, were associated with severely (23) or moderately (35) active CD. Results: the ADC value decreased from 2.79 ± 0.35 x 10-3 mm2/s for normal segments to 1.81 ± 0.39 x 10-3 mm2/s for the moderately inflamed segments and 1.15 ± 0.20 x 10-3 mm2/s for severely inflamed segments (p ≤ 0.0001). ROC curve analysis on the basis of the three ADC distributions showed a very good discrimination capability with an area under the curve of 0.95. Three groups were defined as follows: normal ileum ADC > 2.4 x 10-3 mm2/s, moderate stages of inflammation 1.5 x 10-3 mm2/s < ADC ≤ 2.4 x 10-3 mm2/s and severe stages of ADC ≤ 1.5 x 10-3 mm2/s. Conclusions: the ADC value reliably discriminates between normal and inflamed ileum and also distinguishes between severe and moderate inflammation.
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Faletti R, Ribaldone D, Gatti M, Perazzini C, Robella M, Angelino F, et all. Apparent diffusion coefficient and enhancement patterns in MR imaging as markers of severe or moderate ileum inflammation in Crohn’s disease. 5691/2018


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Publication history

Received: 02/05/2018

Accepted: 13/07/2018

Online First: 04/10/2018

Published: 17/01/2019

Article revision time: 69 days

Article Online First time: 155 days

Article editing time: 260 days


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