Comparison between Diffusion-Weighted Sequences with Selective and Non-Selective Fat Suppression in the Evaluation of Crohn's Disease Activity: Are They Equally Useful?

Ilze Apine; Reinis Pitura; Ivanda Franckevica; Juris Pokrotnieks; Gaida Krumina

doi:10.3390/diagnostics10060347

Comparison between Diffusion-Weighted Sequences with Selective and Non-Selective Fat Suppression in the Evaluation of Crohn's Disease Activity: Are They Equally Useful?

Diagnostics (Basel). 2020 May 27;10(6):347. doi: 10.3390/diagnostics10060347.

Authors

Ilze Apine^{1

2}, Reinis Pitura², Ivanda Franckevica^{1

3}, Juris Pokrotnieks⁴, Gaida Krumina²

Affiliations

¹ Children Clinical University Hospital of Riga, LV 1004 Riga, Latvia.
² Department of Radiology, Riga Stradin's University, LV 1004 Riga, Latvia.
³ Department of Pathology, Riga Stradin's University, LV 1007 Riga, Latvia.
⁴ Department of Internal Diseases, Riga Stradin's University, LV 1007 Riga, Latvia.

Abstract

Background: We compared the efficiency of two MRI diffusion weighted imaging (DWI) techniques: DWI with SPIR (DWI_SPIR) and DWI with STIR (DWI_STIR), to estimate their eligibility for quantitative assessment of Crohn's disease activity in children and adults. Methods: In inflamed terminal ileum segments (n = 32 in adults, n = 46 in children), Magnetic Resonance Index of Activity (MaRIA) was calculated, ADC values of both DWI techniques were measured, and the corresponding Clermont scores calculated. ADC values of both DWI techniques were compared between both and within each patient group, assessing their mutual correlation. Correlations between MaRIA and the corresponding ADC values, and Clermont scores based on both DWI techniques were estimated. Results: No correlation between ADC of DWI_SPIR and DWI_STIR was observed (rho = 0.27, p = 0.13 in adults, rho = 0.20, p = 0.17 in children). The correlation between MaRIA and Clermont scores was strong in both techniques-in SPIR, rho = 0.93; p < 0.0005 in adults, rho = 0.98, p < 0.0005 in children, and, in STIR, rho = 0.89; p < 0.0005 in adults, rho = 0.95, p < 0.0005 in children. The correlation between ADC and MaRIA was moderate negative for DWI_STIR (rho = 0.93, p < 0.0005 in adults, rho = 0.95, p < 0.0005 in children), but, in DWI_STIR, no correlation between ADC and MaRIA score was observed in adults (rho = -0.001, p = 0.99), whereas children presented low negative correlation (rho = -0.374, p = 0.01). Conclusions: DWI_STIR is not suitable for quantitative assessment of Crohn's disease activity both in children and adult patients.

Keywords: ADC; Clermont score; DWI; DWI fat suppression techniques.; DWIBS; MR enterography; MaRIA; diffusion-weighted imaging; terminal ileitis.