Magnetic resonance enteroclysis in patients with Crohn's disease: Fat saturated T2-weighted sequences for evaluation of inflammatory activity

摘要

Background and aims: To evaluate fat saturated (fs) T2-weighted (w) fast relaxation fast spin echo (FRFSE)-sequences compared to the standard protocol with contrast agent for the evaluation of inflammatory activity in patients with Crohn's Disease (CD). Methods: Fourty-eight patients (male, 17; female, 33; mean age, 37. years) with suspicion of inflammatory activity in proven CD who underwent MR enteroclysis (MRE) at 1.5. T (GE Healthcare) were retrospectively included. Two blinded radiologists analyzed MRE images for presence and extent of CD lesions and degree of local inflammation for fs. T2-w FRFSE and contrast enhanced T1-w images (T2-activity; T1-activity; score, 1-4) in consensus. Furthermore, mural signal intensity (SI) ratios (T2-ratio; T1-ratio) were recorded. Patient based MRE findings were correlated with endoscopic (45 patients), surgical (6 patients), histopathological, and clinical data (CDAI) as a surrogate reference standard. Results: In total, 24 of 48 eligible patients presented with acute inflammatory activity with 123 affected bowel segments. ROC analysis of the total inflammatory score presented an AUC of 0.93 (p. <. 0.001) for T2-activity (T1-activity, AUC 0.63; p=0.019). ROC analysis revealed an AUC of 0.76 (p. <. 0.001) for the T2-ratio (T1-ratio, AUC 0.51; p. =. 0.93). General linear regression model revealed T2-activity (p. =. 0.001) and age (p. =. 0.024) as predictive factors of acute bowel inflammation. Conclusions: T2-w FRFSE-sequences can depict CD lesions and help to assess the inflammation activity, even with improved accuracy as compared to contrast-enhanced T1-w sequences.