title: Addition of diffusion-weighted imaging can improve diagnostic confidence in bowel MRI.
abstract: OBJECTIVE
  To evaluate whether the addition of diffusion-weighted imaging (DWI) in bowel abdominal magnetic resonance imaging (MRI) can improve diagnostic confidence.
  
  
  METHODS
  One hundred and eleven consecutive patients with suspected or known inflammatory bowel disease (n = 59), tumour disease (n = 31), unspecific abdominal pain (n = 16), and suspected graft-versus-host disease (n = 5) underwent bowel MRI using a 1.5 T MRI machine. In addition to T2-weighted (T2W) and contrast-enhanced T1-weighted (CE-T1W) data, axial and coronal DWI sequences were collected (b = 50, 500, 1000). Diagnostic confidence for lesion detection with and without DWI was evaluated using a four-point Likert scale [1 = certainly no lesion(s), 2 = probably no lesion(s), 3 = probably lesion(s), 4 = certainly lesion(s)].
  
  
  RESULTS
  In 11 of 111 patients (10%), the diagnostic confidence was improved by DWI. In seven patients, readers changed their diagnosis from "probable" to "certain presence of lesions". In another four patients, lesions were diagnosed based on DWI, which were not delineated on CE-T1W and T2W imaging.
  
  
  CONCLUSIONS
  DWI of the bowel can provide additional information to the reader and, therefore, improve diagnostic confidence. Hence, additional DWI should be integrated into a standard bowel MRI protocol.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany. Electronic address: Sonja.Kinner@uni-due.de.
authors.forename: S
authors.initials: S
authors.lastname: Kinner
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Blex
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Maderwald
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Forsting
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Gerken
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
authors.forename: T C
authors.initials: TC
authors.lastname: Lauenstein
mesh_terms: D015746:Abdominal Pain / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005858:Germany / Q000453:epidemiology; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D013997:Time Factors
chemical_list: D003287:Contrast Media