Intravoxel incoherent motion diffusion-weighted imaging in quantitative evaluation of Ileal Crohn's disease - A comparison with dynamic contrast-enhanced magnetic resonance imaging and ileocolonoscopy

Peiwen Sun; Diru Zhu; Junheng Li; Jilei Zhang; Meiying Zeng; Leilei Fang; Jianping Ruan; Xiance Zhao; Yanhong Shi; Shuai Wang; Binghui Zhao

doi:10.1016/j.mri.2022.12.020

Intravoxel incoherent motion diffusion-weighted imaging in quantitative evaluation of Ileal Crohn's disease - A comparison with dynamic contrast-enhanced magnetic resonance imaging and ileocolonoscopy

Magn Reson Imaging. 2023 Apr:97:82-90. doi: 10.1016/j.mri.2022.12.020. Epub 2023 Jan 3.

Authors

Peiwen Sun¹, Diru Zhu¹, Junheng Li¹, Jilei Zhang², Meiying Zeng¹, Leilei Fang³, Jianping Ruan¹, Xiance Zhao⁴, Yanhong Shi³, Shuai Wang¹, Binghui Zhao⁵

Affiliations

¹ Department of Radiology, Shanghai Tenth People's Hospital of Tongji University Medical School, Shanghai 200072, China.
² Shanghai MicroPort MedBot, Shanghai 201210, China.
³ Department of Gastroenterology, Shanghai Tenth People's Hospital of Tongji University Medical School, Shanghai 200072, China.
⁴ Clinical Science, Philips Healthcare, Shanghai 200040, PR China.
⁵ Department of Radiology, Shanghai Tenth People's Hospital of Tongji University Medical School, Shanghai 200072, China. Electronic address: binghuizhao@163.com.

PMID: 36608907
DOI: 10.1016/j.mri.2022.12.020

Abstract

Objectives: To investigate the prospective role of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in evaluating terminal ileal Crohn's disease (CD) inflammation quantitatively, compared with quantitative dynamic contrastenhanced magnetic resonance imaging (DCE-MRI) and ileocolonoscopic segmental score.

Methods: Fifty CD patients underwent magnetic resonance enterography (MRE) including IVIM-DWI and quantitative DCE-MRI from Jan. 2017 to Nov. 2019. ADC, D, D* and f value of IVIM-DWI and Ktrans, Kep, and Ve value of DCE-MRI in normal (n = 50) and inflamed bowel segments (n = 50), defined during the clinical MRI analysis, were calculated and compared using Wilcoxon signed-rank tests respectively. Receiver operating characteristic (ROC) analysis was performed. Correlations between IVIM-DWI and DCE-MRI parameters in comparison with ileocolonoscopic segmental score were assessed using Spearman's rank correlation analysis.

Results: For IVIM-DWI, ADC, D, D* and f value showed significant differences respectively between normal and inflamed bowel segments (p < 0.05). ADC value presented the highest diagnostic accuracy (AUC = 0.813) and sensitivity (92%), and D value presented the highest specificity (84%) for the evaluation of inflamed bowel segments. For DCE-MRI, Ktrans value presented the highest diagnostic accuracy (AUC = 0.835), the highest sensitivity for Kep value (88%) and the highest specificity for Ve value (96%). ADC, f and Ktrans value had high correlations with ileocolonoscopic score respectively (r = -0.739-0.876, p < 0.01). The logarithm of normalized signal intensity/b-values for IVIM-DWI could also indicate directly the evident difference between the normal and inflamed bowel segments of terminal ileal CD.

Conclusion: IVIM-DWI will be another promising noninvasive tool to provide precise quantitative-indicators in evaluating inflamed bowel segments of terminal ileal CD with little contrast-agent damage worries.

Keywords: Crohn's disease; Dynamic contrast enhancement; Enterography; Functional MR imaging.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Contrast Media
Crohn Disease* / diagnostic imaging
Diffusion Magnetic Resonance Imaging / methods
Humans
Magnetic Resonance Imaging / methods
ROC Curve

Substances

Contrast Media