M Barat1,2, C Hoeffel3, M Bouquot4,5, A S Jannot6,7, R Dautry8, M Boudiaf8, K Pautrat5, R Kaci9, M Camus10, C Eveno4,5,11, M Pocard4,5,11, P Soyer8,4,12, A Dohan8,4,12. 1. Department of Abdominal and Interventional Imaging, Hôpital Cochin, AP-HP, 27 rue du Faubourg St Jacques, 75014, Paris, France. maxime.barat89@gmail.com. 2. UMR INSERM 965, Hôpital Lariboisière, 2 rue Amboise Paré, 75010, Paris, France. maxime.barat89@gmail.com. 3. Department of Radiology, Hôpital Robert-Debré, Reims, France. 4. UMR INSERM 965, Hôpital Lariboisière, 2 rue Amboise Paré, 75010, Paris, France. 5. Department of Digestive and Oncologic Surgery, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75475, Paris cedex 10, France. 6. INSERM-UMRS 1138 Team 22, Cordeliers Research Center, Paris Descartes University, Paris, France. 7. Department of Medical Informatics and Public Health, European George Pompidou Hospital, AP-HP, 20 Rue Leblanc, 75015, Paris, France. 8. Department of Abdominal and Interventional Imaging, Hôpital Cochin, AP-HP, 27 rue du Faubourg St Jacques, 75014, Paris, France. 9. Department of Pathology, Hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010, Paris, France. 10. Department of Gastroenterology, Hôpital Saint-Antoine (AP-HP), Sorbonne University, Pierre et Marie Curie, Paris, France. 11. Université Sorbonne-Paris Cité, Paris-Diderot, 10 rue de Verdun, 75010, Paris, France. 12. Université Sorbonne Paris Cité, Paris-Descartes, 12 Rue de l'École de Médecine, 75006, Paris, France.
Abstract
PURPOSE: To compare the accuracy of MR enterography (MRE) using combined T2-weighted and contrast-enhanced (CE) sequences with that of combined T2- and diffusion-weighted (DW) sequences for the detection of complex enteric Crohn's disease (CD). MATERIALS: Thirty-eight patients who underwent surgery for CD complications and preoperative MRE from 2011 to 2016 were included. MRE examinations were blindly analyzed independently by one junior and one senior abdominal radiologist for the presence of fistula, stenosis and abscesses. During a first reading session, T2-weighted images (WI), steady-state sequences and DW-MRE were reviewed (set 1). During a separate distant session, T2-WI, True-FISP and CE-MRE were reviewed (set 2). Performance of each reader was evaluated by comparison with the standard of reference established using intraoperative and pathological findings. RESULTS: Forty-eight fistulas, 43 stenoses and 11 abscesses were found. For the senior radiologist, sensitivity for the detection of fistula, stenosis and abscess ranged from 80% to 100% for set 1 and 88% to 100% for set 2 and specificity ranged from 56% to 70% for set 1 and 53% to 93% for set 2, with no significant difference between the sets (p = 0.342-0.429). For the junior radiologist, sensitivity ranged from 53% to 63% for set 1 and 64% to 88% for set 2 and specificity ranged from 0% to 25% for set 1 and 17% to 40% for set 2 (p = 0.001 and 0.007, respectively). CONCLUSION: For a senior radiologist, DW-MRE has similar sensitivity as CE-MRE for the detection of CD complications. For a junior radiologist, CE-MRE yields the best results compared with DW-MRE. KEY POINTS: • For experienced readers, DWI has similar diagnostic capability as contrast-enhanced MR imaging for the diagnosis of Crohn's disease complications. • For senior radiologists, gadolinium chelate injection could be waived for the diagnosis of Crohn's disease complications. • The interpretation of DWI for Crohn's disease complications requires some experience.
PURPOSE: To compare the accuracy of MR enterography (MRE) using combined T2-weighted and contrast-enhanced (CE) sequences with that of combined T2- and diffusion-weighted (DW) sequences for the detection of complex enteric Crohn's disease (CD). MATERIALS: Thirty-eight patients who underwent surgery for CD complications and preoperative MRE from 2011 to 2016 were included. MRE examinations were blindly analyzed independently by one junior and one senior abdominal radiologist for the presence of fistula, stenosis and abscesses. During a first reading session, T2-weighted images (WI), steady-state sequences and DW-MRE were reviewed (set 1). During a separate distant session, T2-WI, True-FISP and CE-MRE were reviewed (set 2). Performance of each reader was evaluated by comparison with the standard of reference established using intraoperative and pathological findings. RESULTS: Forty-eight fistulas, 43 stenoses and 11 abscesses were found. For the senior radiologist, sensitivity for the detection of fistula, stenosis and abscess ranged from 80% to 100% for set 1 and 88% to 100% for set 2 and specificity ranged from 56% to 70% for set 1 and 53% to 93% for set 2, with no significant difference between the sets (p = 0.342-0.429). For the junior radiologist, sensitivity ranged from 53% to 63% for set 1 and 64% to 88% for set 2 and specificity ranged from 0% to 25% for set 1 and 17% to 40% for set 2 (p = 0.001 and 0.007, respectively). CONCLUSION: For a senior radiologist, DW-MRE has similar sensitivity as CE-MRE for the detection of CD complications. For a junior radiologist, CE-MRE yields the best results compared with DW-MRE. KEY POINTS: • For experienced readers, DWI has similar diagnostic capability as contrast-enhanced MR imaging for the diagnosis of Crohn's disease complications. • For senior radiologists, gadolinium chelate injection could be waived for the diagnosis of Crohn's disease complications. • The interpretation of DWI for Crohn's disease complications requires some experience.
Entities:
Keywords:
Comparative studies; Crohn’s disease; Diffusion MRI; Magnetic resonance imaging
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