Evaluation of diffusion-weighted MR imaging for detection of bowel inflammation in patients with Crohn's disease.
OBJECTIVE
The aims of this study were to determine the feasibility of diffusion-weighted magnetic resonance imaging (DWI) in the detection of bowel inflammation and to investigate the changes in apparent diffusion coefficient (ADC) values in the inflamed bowel in patients with Crohn's disease.


METHODS
Eleven patients who underwent magnetic resonance enterography (including DWI) for Crohn's disease and colonoscopy or surgery within 4 weeks of examination were recruited. Two radiologists reviewed diffusion-weighted images and ADC maps to evaluate for inflammation in each bowel segment (terminal ileum, cecum, ascending colon, transverse colon, descending colon, and rectosigmoid colon) and measured the ADC values of each bowel segment. Endoscopic and pathologic results were correlated with DWI findings.


RESULTS
Fifty-three segments (19 with inflammation, 34 normal) were included. DWI detected inflammation in 18 of 19 segments (94.7%) and showed normal results in 28 of 34 segments (82.4%). On diffusion-weighted images, bowel segments with inflammation revealed higher signal compared to normal segments. Artifact levels were none or minimal in 10 of 11 patients (90.9%) and moderate in one patient. On quantitative analysis, ADC values of inflamed and normal bowel were measured as 0.47 - 2.60 x 10(-3) and 1.39 - 4.03 x 10(-3) mm(2)/s, respectively (P < .05).


CONCLUSIONS
DWI with parallel imaging is a feasible technique for the detection of inflammation in patients with Crohn's disease. ADC values are decreased in inflamed bowel segments, indicating restricted diffusion.
Oto
Aytekin
A
Department of Radiology, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, USA. aoto@radiology.bsd.uchicago.edu
Zhu
Fang
F
Kulkarni
Kirti
K
Karczmar
Gregory S
GS
Turner
Jerrold R
JR
Rubin
David
D
D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004751:Enteritis / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity