Jordan B Rapp1, Sudha A Anupindi2,3, Carolina L Maya2, David M Biko2,3. 1. Department of Radiology, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA. rappj@email.chop.edu. 2. Department of Radiology, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA. 3. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Abstract
BACKGROUND: Diffusion restriction has been utilized as a marker for bowel inflammation on magnetic resonance enterography (MRE). However, diffusion restriction has been seen in otherwise normal appearing small bowel in patients without active inflammation, with little published data on this subject. OBJECTIVE: Assess diffusion restriction in normal loops of jejunum and to determine if there is a correlation to luminal distention, age, magnet field strength, slice thickness, and bowel segment location. MATERIALS AND METHODS: A retrospective analysis of subjects with a normal MRE and clinical work-up was performed. The abdomen was divided into four quadrants. If available, two loops of jejunum were randomly chosen in each quadrant. Two radiologists evaluated the loops of jejunum for distension, wall thickness, enhancement and diffusion restriction. Disagreement was resolved by consensus. Presence of diffusion restriction was correlated with luminal distension, age, magnet field strength, slice thickness and abdominal quadrant. RESULTS: One hundred ninety-seven loops of jejunum were evaluated in 39 subjects. Fifteen subjects (38.5%) had jejunal loops with diffusion restriction for a total of 28 loops. There was no correlation between diffusion restriction and luminal distension, age, magnet field strength or quadrant location (P>0.05, Pearson chi-squared test or Student's t-tests). Of the 15 subjects with a loop demonstrating diffusion restriction, additional loops with diffusion restriction were found in 40%. There was a very weak trend observed for greater slice thickness in patients with jejunal diffusion restriction (Student's t-test, P=0.10). CONCLUSION: Jejunal diffusion restriction is a common finding in children with no clinical evidence of bowel pathology, irrespective of patient age, luminal distension, location of bowel loop and magnetic field strength. Further studies may be valuable in assessing the impact of slice thickness on subjective diffusion restriction in the jejunum.
BACKGROUND: Diffusion restriction has been utilized as a marker for bowel inflammation on magnetic resonance enterography (MRE). However, diffusion restriction has been seen in otherwise normal appearing small bowel in patients without active inflammation, with little published data on this subject. OBJECTIVE: Assess diffusion restriction in normal loops of jejunum and to determine if there is a correlation to luminal distention, age, magnet field strength, slice thickness, and bowel segment location. MATERIALS AND METHODS: A retrospective analysis of subjects with a normal MRE and clinical work-up was performed. The abdomen was divided into four quadrants. If available, two loops of jejunum were randomly chosen in each quadrant. Two radiologists evaluated the loops of jejunum for distension, wall thickness, enhancement and diffusion restriction. Disagreement was resolved by consensus. Presence of diffusion restriction was correlated with luminal distension, age, magnet field strength, slice thickness and abdominal quadrant. RESULTS: One hundred ninety-seven loops of jejunum were evaluated in 39 subjects. Fifteen subjects (38.5%) had jejunal loops with diffusion restriction for a total of 28 loops. There was no correlation between diffusion restriction and luminal distension, age, magnet field strength or quadrant location (P>0.05, Pearson chi-squared test or Student's t-tests). Of the 15 subjects with a loop demonstrating diffusion restriction, additional loops with diffusion restriction were found in 40%. There was a very weak trend observed for greater slice thickness in patients with jejunal diffusion restriction (Student's t-test, P=0.10). CONCLUSION: Jejunal diffusion restriction is a common finding in children with no clinical evidence of bowel pathology, irrespective of patient age, luminal distension, location of bowel loop and magnetic field strength. Further studies may be valuable in assessing the impact of slice thickness on subjective diffusion restriction in the jejunum.
Entities:
Keywords:
Children; Crohn disease; Diffusion-weighted imaging; Jejunum; Magnetic resonance enterography; Small bowel
Authors: Karin Horsthuis; Lissy de Ridder; Anne M J B Smets; Maarten S van Leeuwen; Marc A Benninga; Roderick H J Houwen; Annemieke S Littooij; Rutger A J Nievelstein; Jaap Stoker Journal: J Pediatr Gastroenterol Nutr Date: 2010-11 Impact factor: 2.839
Authors: Zehour AlSabban; Peter Church; Rahim Moineddin; Oscar M Navarro; Mary-Louise Greer; Thomas Walters; Govind B Chavhan Journal: Clin Imaging Date: 2016-09-28 Impact factor: 1.605
Authors: Eric C Ehman; Andrew S Phelps; Michael A Ohliger; Sue J Rhee; John D MacKenzie; Jesse L Courtier Journal: Clin Imaging Date: 2016-07-21 Impact factor: 1.605
Authors: C Hordonneau; A Buisson; J Scanzi; F Goutorbe; B Pereira; C Borderon; D Da Ines; P F Montoriol; J M Garcier; L Boyer; G Bommelaer; V Petitcolin Journal: Am J Gastroenterol Date: 2013-11-19 Impact factor: 10.864
Authors: D A Pendsé; J C Makanyanga; A A Plumb; G Bhatnagar; D Atkinson; Manuel Rodriguez-Justo; S Halligan; S A Taylor Journal: Abdom Radiol (NY) Date: 2017-01