Literature DB >> 26838954

Prospective evaluation of free-breathing diffusion-weighted imaging for the detection of inflammatory bowel disease with MR enterography in childhood population.

Céline Dubron1, Freddy Avni1, Nathalie Boutry1, Dominique Turck2, Alain Duhamel3, Elisa Amzallag-Bellenger1.   

Abstract

OBJECTIVE: To evaluate prospectively the performance of diffusion-weighted imaging (DWI) for the detection of active lesions on MR enterography (MRE) in children with inflammatory bowel disease (IBD).
METHODS: MRE of 48 children (mean age 13 years) with suspected or known IBD were blindly analysed by 2 independent readers for the presence of active lesions. Two sets of imaging including DWI and gadolinium-enhanced imaging (GEI) were reviewed. A reader consensus was obtained. The gold standard was histopathological findings. In patient-level analysis and segment-level analysis, sensitivity and specificity were calculated for DWI and GEI and compared using McNemar's test or logistic random-effects models.
RESULTS: At least 1 active lesion was confirmed in 42 (87.5%) children. Sensitivity and specificity for the detection of at least one lesion were 88.1% (95% CI, 74.3-96.1) and 83.3% (95% CI, 35.9-99.6), respectively, for DWI and 66.7% (95% CI, 50.4-80.4) and 83.3% (95% CI, 35.9-99.6), respectively, for GEI. In segment-level analysis, sensitivity and specificity for the detection of specific segment lesions were 62.5% (95% CI, 48.1-75) and 97.1% (95% CI, 93.5-98.7), respectively, for DWI and 45.7% (95% CI, 30.8-61.3) and 98.2% (95% CI, 95.3-99.4), respectively, for GEI. The sensitivity of DWI was significantly better than that of GEI per patient (p = 0.004) and per segment (p = 0.028).
CONCLUSION: DWI demonstrates better performance than GEI for the detection of active lesions in children with IBD. ADVANCES IN KNOWLEDGE: Examination with no intravenous injection-DWI can replace T1 weighted images when paediatric patients are screened with MRE for IBD. Examination performed in free breathing is better tolerated by children.

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Year:  2016        PMID: 26838954      PMCID: PMC4846210          DOI: 10.1259/bjr.20150840

Source DB:  PubMed          Journal:  Br J Radiol        ISSN: 0007-1285            Impact factor:   3.039


  38 in total

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