Crohn disease with endoscopic correlation: single-shot fast spin-echo and gadolinium-enhanced fat-suppressed spoiled gradient-echo MR imaging.
OBJECTIVE
To compare T2-weighted breath-hold single-shot fast spin-echo (SE) and gadolinium-enhanced spoiled gradient-echo (GRE) MR imaging with contrast material administered orally and rectally for evaluating patients with Crohn disease.


METHODS
Twenty-eight patients with Crohn disease received 2% barium sulfate and water enema. The abdomen and pelvis were imaged with transverse and coronal single-shot fast SE and gadolinium-enhanced spoiled GRE MR imaging. Two radiologists reviewed the two types of images for bowel disease. The extent, severity, and conspicuity of the disease were determined. Proof of bowel disease at MR imaging was compared with that at endoscopy, barium study, and surgery. Statistical analysis was performed with the McNemar test.


RESULTS
Twenty-five of 28 patients had proven abnormal bowel segments. The per-patient sensitivity of gadolinium-enhanced spoiled GRE MR imaging for the two radiologists was 100% and 96% versus 60% and 60% (P <.05) with single-shot fast SE MR imaging. Gadolinium-enhanced spoiled GRE MR images depicted more segments (54 and 52 of 61 segments; sensitivity, 89% and 85%, respectively) of the diseased bowel than did single-shot fast SE MR images (31 and 32 of 61 segments; sensitivity, 51% and 52%, respectively; P <.001). Severity of Crohn disease was correctly depicted at gadolinium-enhanced spoiled GRE imaging in 93% of patients versus in 43% of patients at single-shot fast SE imaging.


CONCLUSIONS
In patients with Crohn disease, gadolinium-enhanced fat-suppressed spoiled GRE MR imaging better depicted the extent and severity of intestinal disease compared with single-shot fast SE imaging.
Low
Russell N
RN
Sharp and Children's MRI Center and Department of Radiology, Sharp Memorial Hospital, 7901 Frost St, San Diego, CA 92123, USA. rlow@ucsd.edu
Sebrechts
Christopher P
CP
Politoske
Douglas A
DA
Bennett
Michael T
MT
Flores
Sergio
S
Snyder
Richard J
RJ
Pressman
Jeffrey H
JH
D000328:Adult; D001466:Barium Sulfate; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003951:Diagnostic Errors; D016099:Endoscopy, Gastrointestinal; D004733:Enema; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007420:Intestine, Large / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media; D001466:Barium Sulfate; C064925:gadodiamide; D019786:Gadolinium DTPA