Dynamic contrast enhanced magnetic resonance imaging of the terminal ileum: differentiation of activity of Crohn’s disease

• Published in: Abdominal imaging 2008-07, Vol.33 (4), p.417-424
• Main Authors: Del Vescovo, Riccardo, Sansoni, Ilaria, Caviglia, Renato, Ribolsi, Mentore, Perrone, Giuseppe, Leoncini, Emanuele, Grasso, Rosario Francesco, Cicala, Michele, Zobel, Bruno Beomonte
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Contrast Media; Crohn Disease - diagnosis; Diagnosis, Differential; Endoscopy, Gastrointestinal; Female; Gadolinium DTPA; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Hepatology; Humans; Ileum; Imaging; Magnetic Resonance Imaging - methods; Male; Medical sciences; Medicine; Medicine & Public Health; Nephrology. Urinary tract diseases; Other diseases. Semiology; Prospective Studies; Radiology; Statistics, Nonparametric; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
• ISSN: 0942-8925; 2366-004X; 1432-0509; 2366-0058
• DOI: 10.1007/s00261-007-9267-4

Aim To prospectively investigate a new high resolution MRI technique for dynamic evaluation of the enhancement kinetics of bowel parietal layers and to correlate it with CDAI, CRP, endoscopic activity and histologic features. Methods About 16 consecutive patients with proven diagnosis of CD underwent ileocolonoscopy with biopsy and serial bowel dynamic contrasted-MRI (D-CE-MRI) evaluated in blind fashion. Quantitative analysis of bowel wall enhancement kinetics was performed basing on signal to noise ratio (SNR) of inner parietal layers (Mucosa–Submucosa, M–SM) and outer parietal layers (Muscular–Serosa, Ms–S). Disease activity was defined by CDAI > 150, serum CRP > 5 mg/dL and histologic results. Results About 9 patients showed a layered enhancement of bowel wall (8 active, 1 inactive), whereas inactive (7 cases) group presented a homogeneous pattern. In active patients we found a significant difference in parietal layered enhancement curves (M–SM vs. Ms–S, P