Dynamic contrast-enhanced MRI in patients with luminal Crohn's disease

• Published in: European journal of radiology 2012-11, Vol.81 (11), p.3019-3027
• Main Authors: Ziech, M.L.W, Lavini, C, Caan, M.W.A, Nio, C.Y, Stokkers, P.C.F, Bipat, S, Ponsioen, C.Y, Nederveen, A.J, Stoker, J
• Format: Article
• Language: English
• Subjects: Adult; Contrast Media; Crohn Disease - pathology; Crohn's disease; DCE-MRI; Female; Humans; Inflammatory bowel diseases; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Organometallic Compounds; Radiology; Reproducibility of Results; Sensitivity and Specificity
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2012.03.028

Abstract Objectives To prospectively assess dynamic contrast-enhanced (DCE-)MRI as compared to conventional sequences in patients with luminal Crohn's disease. Methods Patients with Crohn's disease undergoing MRI and ileocolonoscopy within 1 month had DCE-MRI (3T) during intravenous contrast injection of gadobutrol, single shot fast spin echo sequence and 3D T1-weighted spoiled gradient echo sequence, a dynamic coronal 3D T1-weighted fast spoiled gradient were performed before and after gadobutrol. Maximum enhancement (ME) and initial slope of increase (ISI) were calculated for four colon segments (ascending colon + coecum, transverse colon, descending colon + sigmoid, rectum) and (neo)terminal ileum. C-reactive protein (CRP), Crohn's disease activity index (CDAI), per patient and per segment Crohn's disease endoscopic index of severity (CDEIS) and disease duration were determined. Mean values of the (DCE-)MRI parameters in each segment from each patient were compared between four disease activity groups (normal mucosa, non-ulcerative lesions, mild ulcerative and severe ulcerative disease) with Mann–Whitney test with Bonferroni adjustment. Spearman correlation coefficients were calculated for continuous variables. Results Thirty-three patients were included (mean age 37 years; 23 females, median CDEIS 4.4). ME and ISI correlated weakly with segmental CDEIS ( r = 0.485 and r = 0.206) and ME per patient correlated moderately with CDEIS ( r = 0.551). ME was significantly higher in segments with mild (0.378) or severe (0.388) ulcerative disease compared to normal mucosa (0.304) ( p < 0.001). No ulcerations were identified at conventional sequences. ME correlated with disease duration in diseased segments ( r = 0.492), not with CDAI and CRP. Conclusions DCE-MRI can be used as a method for detecting Crohn's disease ulcerative lesions.