Diagnostic Value of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient in Assessment of the Activity of Crohn Disease: 1.5 or 3 T

J Comput Assist Tomogr. 2018 Sep/Oct;42(5):688-696. doi: 10.1097/RCT.0000000000000754.

Abstract

Objective: The objective of this study is to evaluate the role of diffusion-weighted imaging (DWI) in assessment of the activity of Crohn disease (CD) and to explore differences between DWI in 3 T and 1.5 T.

Methods: Postcontrast magnetic resonance enterography with DWI of 72 patients with pathological proof of CD was retrospectively evaluated for restricted diffusion qualitatively and quantitavely in 3 T (n = 40) and 1.5 T (n = 32). Magnetic resonance activity score of 7 or higher was used as reference of activity.

Results: Fifty-five patients had active lesions. Diffusion-weighted imaging hyperintensity showed sensitivity (100%, 100%) and specificity (88.89%, 100%) in 1.5/3 T for activity assessment. Mean ± SD apparent diffusion coefficient for active lesions was 1.21 ± 0.42 and 1.28 ± 0.59 × 10 mm/s in 1.5 and 3 T, respectively. The proposed cutoff values of 1.35 and 1.38 × 10 mm/s in 1.5 and 3 T, respectively, had sensitivity (80%, 93%), specificity (100%, 90%), accuracy (88%, 93%), and no significant difference in accuracy between 1.5/3 T (P = 0.48).

Conclusions: Diffusion-weighted imaging hypersensitivity and apparent diffusion coefficient values accurately assessed the activity of CD. No significant statistical difference in diagnostic accuracy was detected between 1.5 and 3 T.

MeSH terms

  • Adult
  • Crohn Disease / diagnostic imaging*
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Gastrointestinal Tract / diagnostic imaging*
  • Humans
  • Male
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index