Print Email Facebook Twitter Comparison of contrast-enhanced and diffusion-weighted MRI in assessment of the terminal ileum in Crohn’s disease patients Title Comparison of contrast-enhanced and diffusion-weighted MRI in assessment of the terminal ileum in Crohn’s disease patients Author Puylaert, Carl A.J. (Universiteit van Amsterdam) Tielbeek, Jeroen A.W. (Universiteit van Amsterdam) Schüffler, Peter J. (Memorial Sloan-Kettering Cancer Center; ETH Zürich) Nio, C. Yung (Universiteit van Amsterdam) Horsthuis, Karin (Vrije Universiteit Amsterdam) Mearadji, Banafsche (Universiteit van Amsterdam) Ponsioen, Cyriel Y. (Universiteit van Amsterdam) Vos, F.M. (TU Delft ImPhys/Quantitative Imaging; Universiteit van Amsterdam) Stoker, Jaap (Universiteit van Amsterdam) Date 2018 Abstract Purpose: The purpose of the study was to compare the performance of contrast-enhanced (CE)-MRI and diffusion-weighted imaging (DW)-MRI in grading Crohn’s disease activity of the terminal ileum. Methods: Three readers evaluated CE-MRI, DW-MRI, and their combinations (CE/DW-MRI and DW/CE-MRI, depending on which protocol was used at the start of evaluation). Disease severity grading scores were correlated to the Crohn’s Disease Endoscopic Index of Severity (CDEIS). Diagnostic accuracy, severity grading, and levels of confidence were compared between imaging protocols and interobserver agreement was calculated. Results: Sixty-one patients were included (30 female, median age 36). Diagnostic accuracy for active disease for CE-MRI, DW-MRI, CE/DW-MRI, and DW/CE-MRI ranged between 0.82 and 0.85, 0.75 and 0.83, 0.79 and 0.84, and 0.74 and 0.82, respectively. Severity grading correlation to CDEIS ranged between 0.70 and 0.74, 0.66 and 0.70, 0.69 and 0.75, and 0.67 and 0.74, respectively. For each reader, CE-MRI values were consistently higher than DW-MRI, albeit not significantly. Confidence levels for all readers were significantly higher for CE-MRI compared to DW-MRI (P < 0.001). Further increased confidence was seen when using combined imaging protocols. Conclusions: There was no significant difference of CE-MRI and DW-MRI in determining disease activity, but the higher confidence levels may favor CE-MRI. DW-MRI is a good alternative in cases with relative contraindications for the use of intravenous contrast medium. Subject Comparative studyContrast mediaCrohn diseaseDiffusion magnetic resonance imagingMagnetic resonance imaging To reference this document use: http://resolver.tudelft.nl/uuid:49a81466-121e-4a58-8739-82d20777effd DOI https://doi.org/10.1007/s00261-018-1734-6 ISSN 2366-004X Source Abdominal Radiology Part of collection Institutional Repository Document type journal article Rights © 2018 Carl A.J. Puylaert, Jeroen A.W. Tielbeek, Peter J. Schüffler, C. Yung Nio, Karin Horsthuis, Banafsche Mearadji, Cyriel Y. Ponsioen, F.M. Vos, Jaap Stoker Files PDF Puylaert2018_Article_Comp ... ancedA.pdf 877.92 KB Close viewer /islandora/object/uuid:49a81466-121e-4a58-8739-82d20777effd/datastream/OBJ/view