title: Magnetic resonance enteroclysis in patients with Crohn's disease: fat saturated T2-weighted sequences for evaluation of inflammatory activity.
abstract: OBJECTIVE
  To evaluate fat saturated (fs) T2-weighted (w) fast relaxation fast spin echo (FRFSE)-sequences compared to the standard protocol with contrast agent for the evaluation of inflammatory activity in patients with Crohn's Disease (CD).
  
  
  METHODS
  Fourty-eight patients (male, 17; female, 33; mean age, 37 years) with suspicion of inflammatory activity in proven CD who underwent MR enteroclysis (MRE) at 1.5T (GE Healthcare) were retrospectively included. Two blinded radiologists analyzed MRE images for presence and extent of CD lesions and degree of local inflammation for fsT2-w FRFSE and contrast enhanced T1-w images (T2-activity; T1-activity; score, 1-4) in consensus. Furthermore, mural signal intensity (SI) ratios (T2-ratio; T1-ratio) were recorded. Patient based MRE findings were correlated with endoscopic (45 patients), surgical (6 patients), histopathological, and clinical data (CDAI) as a surrogate reference standard.
  
  
  RESULTS
  In total, 24 of 48 eligible patients presented with acute inflammatory activity with 123 affected bowel segments. ROC analysis of the total inflammatory score presented an AUC of 0.93 (p<0.001) for T2-activity (T1-activity, AUC 0.63; p=0.019). ROC analysis revealed an AUC of 0.76 (p<0.001) for the T2-ratio (T1-ratio, AUC 0.51; p=0.93). General linear regression model revealed T2-activity (p=0.001) and age (p=0.024) as predictive factors of acute bowel inflammation.
  
  
  CONCLUSIONS
  T2-w FRFSE-sequences can depict CD lesions and help to assess the inflammation activity, even with improved accuracy as compared to contrast-enhanced T1-w sequences.
authors.affiliation: Klinik für Radiologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. christian.grieser@charite.de
authors.forename: Christian
authors.initials: C
authors.lastname: Grieser
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Ingo G
authors.initials: IG
authors.lastname: Steffen
authors.forename: Scarlett
authors.initials: S
authors.lastname: Werner
authors.forename: Thomas
authors.initials: T
authors.lastname: Kröncke
authors.forename: Olaf
authors.initials: O
authors.lastname: Guckelberger
authors.forename: Ulrich-Frank
authors.initials: UF
authors.lastname: Pape
authors.forename: Johannes
authors.initials: J
authors.lastname: Meier
authors.forename: Regina
authors.initials: R
authors.lastname: Thiel
authors.forename: Dietmar
authors.initials: D
authors.lastname: Kivelitz
authors.forename: Andreas
authors.initials: A
authors.lastname: Sturm
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Rainer
authors.initials: R
authors.lastname: Röttgen
mesh_terms: D000328:Adult; D019540:Area Under Curve; D002097:C-Reactive Protein / Q000378:metabolism; D003092:Colitis / Q000150:complications / Q000175:diagnosis*; D003287:Contrast Media; D003424:Crohn Disease / Q000209:etiology / Q000276:immunology* / Q000473:pathology; D004751:Enteritis / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007079:Ileitis / Q000150:complications / Q000175:diagnosis; D007579:Jejunal Diseases / Q000150:complications / Q000175:diagnosis*; D007958:Leukocyte Count; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D011349:Proctitis / Q000150:complications / Q000175:diagnosis*; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D002097:C-Reactive Protein