title: Value of DW-MRI ADC quantification of colonic wall lesions in differentiation of inflammatory bowel disease and colorectal carcinoma.
abstract: OBJECTIVE
  The purpose of our study was to assess the efficiency of diffusion-weighted magnetic resonance imaging (DW-MRI) and the quantification of apparent diffusion coefficient (ADC) values in differentiating colorectal carcinoma from colonic inflammatory bowel disease (IBD) in cases with isolated colonic wall lesions and uncertain clinical and radiologic diagnostic criteria.
  
  
  METHODS
  The study comprised 58 patients with segmental or focal isolated colonic wall thickening. All lacked satisfactory clinical-radiological findings for etiology determination. The mean ADC values of the thickened colonic walls were retrospectively compared with final histopathologic diagnoses. Receiver operating characteristic (ROC) curve analysis was used to determine the ADC cutoff value for differentiation.
  
  
  RESULTS
  Mean ADC value in the colorectal carcinoma group was significantly lower than that in the IBD group: n = 27, 1.02 ± 0.26 × 10(-3) mm(2)/s; and n = 31, 1.53 ± 0.19 × 10(-3) mm(2)/s, respectively (P < 0.001). Cutoff ADC value for differentiating colorectal carcinoma from IBD was calculated as 1.39 × 10(-3) mm(2)/s, with 83.9 % sensitivity and 85.2 % specificity.
  
  
  CONCLUSIONS
  ADC measurement of the involved colonic wall segments with DW-MRI has the potential to differentiate isolated colonic IBD from colorectal carcinoma in cases in which clinical-radiologic findings are insufficient for a definitive diagnosis.
authors.affiliation: Radiology Department, Yuzuncu Yil University, Ercis Yolu, Van, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Avcu
authors.forename: Mehmet Deniz
authors.initials: MD
authors.lastname: Bulut
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Yavuz
authors.forename: Aydın
authors.initials: A
authors.lastname: Bora
authors.forename: Mehmet
authors.initials: M
authors.lastname: Beyazal
mesh_terms: D002277:Carcinoma / Q000175:diagnosis*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged