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• Clinical Article •
The diagnostic value of MR enterography and apparent diffusion coefficient in diffusion-weighted imaging for assessment of activity in Crohn disease
YANG Kele  LI Xiang  WANG Xingdong  LI Delong  ZHU Qingqiang  CHEN Wenxin 

Cite this article as: Yang KL, Li X, Wang XD, et al. The diagnostic value of MR enterography and apparent diffusion coefficient in diffusion-weighted imaging for assessment of activity in Crohn disease. Chin J Magn Reson Imaging, 2020, 11(1): 40-44. DOI:10.12015/issn.1674-8034.2020.01.009.


[Abstract] Objective: To investigate the diagnostic value of MR enterography and apparent diffusion coefficient (ADC) in diffusion-weighted imaging (DWI) for assessment of activity in Crohn disease (CD).Materials and Methods: Fourty-nine patients underwent examination on 3.0 T MR system to achieve the activity of CD. Clinical diagnosis was considered as the gold standard, to which the MR enterography achieved activities were compared. The manifestations under comparisons were wall thickening, increased enhancement, DWI and ADC values, stenosis, comb sign, enlarged lymph node, fistula, ulceration, cellulitis and abscess. ADC values of abnormal and normal bowel walls were compared by applying independent-sample t test.Results: A total amount of 116 abnormal bowel segments [mean (8.18±0.29) mm] were detected from 232 segments obtained by applying MR enterography. On T1-weighted fat-saturated images, 39 out of 41 abnormal bowel-wall manifested moderate or obvious enhancement. In activity of CD patients, stenosis with prestenotic dilatation was observed in 18 out of 41 patients. Comb sign was evident in 22 out of 41 patients. Enlarged mesentcric lymph node was observed in 19 out of 41 patients. Ulceration was detected in 21 out of 41 patients. Fistula was detected in 13 of 41 pailents. Abscess was detected in 2 out of 41 patients. On eDWl (b=1000), the normal bowel wall showed hyper-intensity. The ADC values of the activity and non-activity bowel wall were (0.89—1.31)×10-3 mm2/s and (1.51—1.90)×10-3 mm2/s respectively. Moreover, there was observed statistically significant difference in mean ADC value between abnormal and normal bowel wall (t=7.997, P<0.01). Using an ADC value of 1.145×10-3 mm2/s as the threshold value for differenting activity from non-activity, the best result obtained had a sensitivity of 100%, specificity of 73.2%. Sensitivity of MR enterography for the depiction of the activity of Crolm's disease was 97.4%, where specificity, positive predictive value and negative predictive value were 80.0%, 95.0%, and 88.9% (Kappa=0.832, P<0.05) respectively.Conclusions: MR entrograpghy was acceptably effective in differentiating active and remissive Crohn disease.
[Keywords] Crohn disease；enteroclysis；magnetic resonance imaging

YANG Kele Department of Imaging, Yangzhou Hospital of Traditional Chinese Medicin, Jiangsu Province, Yangzhou 225009, China

LI Xiang Department of Imaging, Yangzhou Hospital of Traditional Chinese Medicin, Jiangsu Province, Yangzhou 225009, China

WANG Xingdong Department of Imaging, Yangzhou Hospital of Traditional Chinese Medicin, Jiangsu Province, Yangzhou 225009, China

LI Delong Department of Imaging, Yangzhou Hospital of Traditional Chinese Medicin, Jiangsu Province, Yangzhou 225009, China

ZHU Qingqiang Department of imaging, subei people's hospital, Jiangsu Province, Yangzhou 225001, China

CHEN Wenxin* Department of imaging, subei people's hospital, Jiangsu Province, Yangzhou 225001, China

*Correspondence to: Chen WX, E-mail: chenwenxinsbyy@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  Yangzhou City Science and Education Strengthening Key Talents Project No. ZDRC201873
Received  2019-07-26
Accepted  2019-11-23
DOI: 10.12015/issn.1674-8034.2020.01.009
Cite this article as: Yang KL, Li X, Wang XD, et al. The diagnostic value of MR enterography and apparent diffusion coefficient in diffusion-weighted imaging for assessment of activity in Crohn disease. Chin J Magn Reson Imaging, 2020, 11(1): 40-44. DOI:10.12015/issn.1674-8034.2020.01.009.

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