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• Clinical Article •
Comparison study on differentiating active from remissive Crohn's disease by 3.0 T and 1.0 T MRI
ZHU Zhen-ya  ZHU Jiong  LI Lei  GONG Hong-xia  XU Jian-rong 

DOI:10.3969/j.issn.1674-8034.2012.06.008.


[Abstract] Objective: To investigate whether 3.0 T MRI can offer better diagnostic value over 1.0 T MRI for evaluating the disease activity of Crohn's disease (CD).Materials and Methods: 36 patients were examined with a 3.0 T MR system and 30 patients were examined with a 1.0 T MR system to evaluate the activity of CD compared with clinical diagnosis based on manifesting wall thickening, increased enhancement, stenosis, "comb sign," enlarged lymph node, fistula, ulceration, and abscess. Clinical diagnosis is the "gold standard" . MRI morphology of each patient was scored by two radiologists. If the score of a patient was ≥4, the patient was diagnosed as active CD. The statistical analysis of bowel wall thickness measurement was independent-samples t-test. The statistical analysis of the display rate of the MRI morphology was chi-square test.Results: The clinical reference standard revealed 25 in 3.0 T MR group (25/36) and 22 in 1.0 T MRI group (22/30) to have active disease at the time of presentation. The mean wall thickness of 76 disorder segments out of 216 measured by 3.0 T MRI was (3.22±0.93) mm. On the 3.0 T MR T1-weighted fat-saturated images, 62 of 76 disorder segment were detect significant enhancement. In 3.0 T MR group, stenosis with prestenotic dilatation was seen in 7, "comb sign" was evident in 20 cases, enlarged mesareic lymph node was seen in 9 cases, ulceration was detected in 2 cases, fistula was detected in 4 cases. Among the 36 patients examined with 3.0 T MR, the mean of the scores was 3.22±1.27. Eighteen cases had a score ≥4, thus indicating active CD. Sensitivity of 3.0 T MR for the depiction of the disease activity of CD was 68.0% (17/25), specificity was 90.9% (10/11), positive predictive value was 94.4% (17/18), negative predictive value was 55.6% (10/18). The mean wall thickness of 69 disorder segments out of 180 measured by 1.0 T MRI was (3.61±0.83) mm. On the 1.0 T MR T1-weighted fat-saturated images, 23 of 69 disorder segment were detect significant enhancement. In 1.0 T MR group, stenosis with prestenotic dilatation was seen in 11 cases, "comb sign" was evident in 6 cases, enlarged mesareic lymph node was seen in 3 cases, ulceration was detected in 3 cases. Among the 30 patients examined with 1.0 T MR, the mean of the scores was 3.13±1.25. 9 cases had a score ≥4, thus indicating active CD. Sensitivity of 1.0 T MR for the depiction of the disease activity of CD was 47.4% (9/19), specificity was 100% (11/11), positive predictive value was 100% (9/9), negative predictive value was 52.4% (11/21). There was significant difference in measuring bowel wall thickness, showing bowl wall enhancement and "comb" sign between 3.0 T and 1.0 T MRI (P<0.05), which showed that 3.0 T was better than 1.0 T MRI.Conclusion: Our results have shown that 3.0 T MRI is more effective in differentiating active and remissive CD than 1.0 T MRI based on measuring bowel thickness, showing increased bowel wall enhancement and the "comb sign" .
[Keywords] Crohn's disease；Severity of illness index；Magnetic resonance imaging

ZHU Zhen-ya Department of Radiology, Renji Hospital, Shang Hai Jiao Tong University School of Medicine, Shanghai 200127, China

ZHU Jiong * Department of Radiology, Renji Hospital, Shang Hai Jiao Tong University School of Medicine, Shanghai 200127, China

LI Lei Department of Radiology, Renji Hospital, Shang Hai Jiao Tong University School of Medicine, Shanghai 200127, China

GONG Hong-xia Department of Radiology, Renji Hospital, Shang Hai Jiao Tong University School of Medicine, Shanghai 200127, China

XU Jian-rong Department of Radiology, Renji Hospital, Shang Hai Jiao Tong University School of Medicine, Shanghai 200127, China

*Correspondence to: Zhu J, E-mail: billzhu49@hotmail.com

Conflicts of interest   None.

Received  2012-05-02
Accepted  2012-07-01
DOI: 10.3969/j.issn.1674-8034.2012.06.008
DOI:10.3969/j.issn.1674-8034.2012.06.008.

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