Año 2019 / Volumen 111 / Número 1
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Año 2019 / Volumen 111 / Número 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

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

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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Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
La REED es el órgano oficial de la Sociedad Española de Patología Digestiva, la Sociedad
Española de Endoscopia Digestiva y la Asociación Española de Ecografía Digestiva
© 2019 Revista Española de Enfermedades Digestivas