Shaojuan Wang1, Xiaowen Tang1, Zhongqiu Wang1, Hao Wang2. 1. Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210009, China. 2. Department of Radiology, Jiangsu Cancer Hospital, Nanjing 210029, China.
Abstract
OBJECTIVE: To explore the value of magnetic resonance diffusion-weighted imaging (MR-DWI) for evaluating inflammatory activity of perianal Crohn's fistula. Methods: A total of 55 patients, who were diagnosed as perianal Crohn's fistula by surgery and/or endoscopy, were assessed retrospectively. All patients, underwent pelvic magnetic resonance imaging (MRI) before and 32 weeks after the treatment, were divided into 2 groups according to their response to treatment: an effective group (34 cases) and an ineffective group (21 cases). The MRI images of patients in the 2 groups were analyzed. The changes of apparent diffusion coefficient (ADC) values before and after treatment in the 2 groups were measured and compared by a paired t-test. An MRI-based score of perianal Crohn's disease severity was calculated as a reference standard, and the correlation between the ADC value and the MRI-based score was analyzed by using a Pearson correlation coefficient method. Results: In the effective group, the ADC values after therapy were significantly greater than those before therapy (P<0.05), but in the ineffective group, there was no significant difference in the ADC value between after and before therapy (P>0.05). There was a strong negative correlation between the ADC values (after and before therapy) and the MRI-based scores in all the patients [in the effective group alone (r=-0.672, P<0.01) or in the effective group + the ineffective group (r=-0.638, P<0.01)]. Conclusion: Changes in the ADC values of perianal fistula are related to the fistula activity. MR-DWI and ADC value can accurately evaluate the inflammatory activity of perianal Crohn's fistula.
OBJECTIVE: To explore the value of magnetic resonance diffusion-weighted imaging (MR-DWI) for evaluating inflammatory activity of perianal Crohn's fistula. Methods: A total of 55 patients, who were diagnosed as perianal Crohn's fistula by surgery and/or endoscopy, were assessed retrospectively. All patients, underwent pelvic magnetic resonance imaging (MRI) before and 32 weeks after the treatment, were divided into 2 groups according to their response to treatment: an effective group (34 cases) and an ineffective group (21 cases). The MRI images of patients in the 2 groups were analyzed. The changes of apparent diffusion coefficient (ADC) values before and after treatment in the 2 groups were measured and compared by a paired t-test. An MRI-based score of perianal Crohn's disease severity was calculated as a reference standard, and the correlation between the ADC value and the MRI-based score was analyzed by using a Pearson correlation coefficient method. Results: In the effective group, the ADC values after therapy were significantly greater than those before therapy (P<0.05), but in the ineffective group, there was no significant difference in the ADC value between after and before therapy (P>0.05). There was a strong negative correlation between the ADC values (after and before therapy) and the MRI-based scores in all the patients [in the effective group alone (r=-0.672, P<0.01) or in the effective group + the ineffective group (r=-0.638, P<0.01)]. Conclusion: Changes in the ADC values of perianal fistula are related to the fistula activity. MR-DWI and ADC value can accurately evaluate the inflammatory activity of perianal Crohn's fistula.
Authors: Khawaja Bilal Waheed; Waseem Jan Shah; Bilal Altaf; Muhammad Amjad; Fawad Hameed; Sana Wasim; Muhammad Zia UlHassan; Zahra Mohammed Abuabdullah; Selvin Nesaraj Rajamonickam; Zechriah Jebakumar Arulanatham Journal: Ann Saudi Med Date: 2020-02-06 Impact factor: 1.526