title: Dynamic contrast-enhanced MRI in patients with luminal Crohn's disease.
abstract: OBJECTIVE
  To prospectively assess dynamic contrast-enhanced (DCE-)MRI as compared to conventional sequences in patients with luminal Crohn's disease.
  
  
  METHODS
  Patients with Crohn's disease undergoing MRI and ileocolonoscopy within 1 month had DCE-MRI (3T) during intravenous contrast injection of gadobutrol, single shot fast spin echo sequence and 3D T1-weighted spoiled gradient echo sequence, a dynamic coronal 3D T1-weighted fast spoiled gradient were performed before and after gadobutrol. Maximum enhancement (ME) and initial slope of increase (ISI) were calculated for four colon segments (ascending colon+coecum, transverse colon, descending colon+sigmoid, rectum) and (neo)terminal ileum. C-reactive protein (CRP), Crohn's disease activity index (CDAI), per patient and per segment Crohn's disease endoscopic index of severity (CDEIS) and disease duration were determined. Mean values of the (DCE-)MRI parameters in each segment from each patient were compared between four disease activity groups (normal mucosa, non-ulcerative lesions, mild ulcerative and severe ulcerative disease) with Mann-Whitney test with Bonferroni adjustment. Spearman correlation coefficients were calculated for continuous variables.
  
  
  RESULTS
  Thirty-three patients were included (mean age 37 years; 23 females, median CDEIS 4.4). ME and ISI correlated weakly with segmental CDEIS (r=0.485 and r=0.206) and ME per patient correlated moderately with CDEIS (r=0.551). ME was significantly higher in segments with mild (0.378) or severe (0.388) ulcerative disease compared to normal mucosa (0.304) (p<0.001). No ulcerations were identified at conventional sequences. ME correlated with disease duration in diseased segments (r=0.492), not with CDAI and CRP.
  
  
  CONCLUSIONS
  DCE-MRI can be used as a method for detecting Crohn's disease ulcerative lesions.
authors: Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.l.ziech@amc.uva.nl
authors: M L W
authors: ML
authors: Ziech
authors: C
authors: C
authors: Lavini
authors: M W A
authors: MW
authors: Caan
authors: C Y
authors: CY
authors: Nio
authors: P C F
authors: PC
authors: Stokkers
authors: S
authors: S
authors: Bipat
authors: C Y
authors: CY
authors: Ponsioen
authors: A J
authors: AJ
authors: Nederveen
authors: J
authors: J
authors: Stoker
mesh_terms: D000328:Adult; D003287:Contrast Media; D003424:Crohn Disease / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol