title: Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn's disease assessment with histopathology of surgical specimens.
abstract: OBJECTIVE
  To prospectively compare conventional MRI sequences, dynamic contrast enhanced (DCE) MRI and diffusion weighted imaging (DWI) with histopathology of surgical specimens in Crohn's disease.
  
  
  METHODS
  3-T MR enterography was performed in consecutive Crohn's disease patients scheduled for surgery within 4 weeks. One to four sections of interest per patient were chosen for analysis. Evaluated parameters included mural thickness, T1 ratio, T2 ratio; on DCE-MRI maximum enhancement (ME), initial slope of increase (ISI), time-to-peak (TTP); and on DWI apparent diffusion coefficient (ADC). These were compared with location-matched histopathological grading of inflammation (AIS) and fibrosis (FS) using Spearman correlation, Kruskal-Wallis and Chi-squared tests.
  
  
  RESULTS
  Twenty patients (mean age 38 years, 12 female) were included and 50 sections (35 terminal ileum, 11 ascending colon, 2 transverse colon, 2 descending colon) were matched to AIS and FS. Mural thickness, T1 ratio, T2 ratio, ME and ISI correlated significantly with AIS, with moderate correlation (r = 0.634, 0.392, 0.485, 0.509, 0.525, respectively; all P < 0.05). Mural thickness, T1 ratio, T2 ratio, ME, ISI and ADC correlated significantly with FS (all P < 0.05).
  
  
  CONCLUSIONS
  Quantitative parameters from conventional, DCE-MRI and DWI sequences correlate with histopathological scores of surgical specimens. DCE-MRI and DWI parameters provide additional information.
  
  
  CONCLUSIONS
  • Conventional MR enterography can be used to assess Crohn's disease activity. • Several MRI parameters correlate with inflammation and fibrosis scores from histopathology. • Dynamic contrast enhanced imaging and diffusion weighted imaging give additional information. • Quantitative MRI parameters can be used as biomarkers to evaluate Crohn's disease activity.
authors.affiliation: Academic Medical Center, Department of Radiology, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands, j.a.w.tielbeek@amc.uva.nl.
authors.forename: Jeroen A W
authors.initials: JA
authors.lastname: Tielbeek
authors.forename: Manon L W
authors.initials: ML
authors.lastname: Ziech
authors.forename: Zhang
authors.initials: Z
authors.lastname: Li
authors.forename: Cristina
authors.initials: C
authors.lastname: Lavini
authors.forename: Shandra
authors.initials: S
authors.lastname: Bipat
authors.forename: Willem A
authors.initials: WA
authors.lastname: Bemelman
authors.forename: Joris J T H
authors.initials: JJ
authors.lastname: Roelofs
authors.forename: Cyriel Y
authors.initials: CY
authors.lastname: Ponsioen
authors.forename: Frans M
authors.initials: FM
authors.lastname: Vos
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003106:Colon / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media
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