Influence of diffusion weighted imaging and contrast enhanced T1 sequences on the diagnostic accuracy of magnetic resonance enterography for Crohn’s disease

• DOI: 10.1016/j.ejrad.2024.111454
• Publication Date: 2024-04-05T22:45:25Z
• Authors: Gauraang Bhatnagar; Sue Mallett; Richard Beable; Rebecca Greenhalgh; Rajapandian Ilang...; Hannah Lambie; Evgenia Mainta; Uday Patel; François Porté; Harbir Sidhu; Arun Gupta; Anthony Higginson; Andrew Slater; Damian Tolan; Ian Zealley; Steve Halligan; Stuart A Taylor
• Keywords: Dynamic contrast; Crohn disease

ObjectivesTo evaluate the additional diagnostic benefit of diffusion weighted imaging (DWI) and contrast enhanced (CE) images during MR enterography (MRE) Crohn's disease.MethodsDatasets from 73 patients (mean age 32; 40 male) (28 new-diagnosis, 45 relapsed) were read independently by two radiologists selected a pool 13. Radiologists interpreted datasets using three sequential sequence blocks: (1) T2 steady state free precession gradient echo (SSFP) alone (T2^); (2) SSFP with DWI (T2 + DWI^) and; (3) images, SSFP, post-contrast T1 CE^), documenting presence, location, activity small bowel disease. For each block, sensitivity specificity (readers combined) was calculated against an outcome-based construct reference standard.Results59/73 had Per-patient for disease detection essentially identical (80 % [95 CI 72, 86], 81 [73,87], 79 [71,86] T2^, DWI^and CE^respectively). Specificity (82 [64 to 92]). Per patient extent 56 (47,65), (47,65) 52 (43 61) respectively, 82 (64 92) all blocks. Sensitivity active 97 (90,99), (90,99) 98 (92,99), also comparable between combination reads. Results consistent across segments newly diagnosed/relapse patients.ConclusionThere is no adding either or CE FSE sequences evaluating disease, suggesting MRE protocols can be simplified safely.