title: Diffusion-weighted imaging for the detection of mesenteric small bowel tumours with Magnetic Resonance--enterography.
abstract: OBJECTIVE
  To retrospectively investigate the added value of diffusion-weighted MR imaging (DWI) for detecting mesenteric small bowel tumours (MSBTs) via MR-enterography.
  
  
  METHODS
  MR-enterographies of 98 patients with suspected MSBTs were blindly analyzed by two independent readers for the presence of MSBTs. Four imaging sets including "standard" (Haste and TrueFisp), "standard + DWI," "standard + gadolinium-enhanced" and "standard + DWI + gadolinium-enhanced" were reviewed. Diagnostic performance of different readings were compared with McNemar's test.
  
  
  RESULTS
  Twenty-nine MSBTs were pathologically confirmed. For R1 (junior radiologist) sensitivity, specificity, PPV, NPV and accuracy for the detection of MSBTs via standard MRI were 52 % [95 % CI: 34 %-70 %] (15/29), 94 % [95 % CI: 89 %-100 %] (65/69), 79 % [95 % CI: 61 %-97 %] (15/19), 82 % [95 % CI: 74 %-91 %] (65/79) and 82 % [95 % CI: 74 %-89 %] (80/98), respectively. For R2 (senior radiologist) they were 76 % [95 % CI: 60 %-91 %] (22/29), 96 % [95 % CI: 91-100 %] (66/69), 88 % [95 % CI: 75 %-100 %] (22/25), 90 % [95 % CI: 84 %-97 %] (66/73) and 90 % [95 % CI: 84 %-96 %] (88/98), respectively. Adding DWI they were 72 % [95 % CI: 56 %-89 %] (21/29), 91 % [95 % CI: 85 %-98 %] (63/69), 78 % [95 % CI: 62 %-94 %] (21/27), 89 % [95 % CI: 81 %-96 %] (63/71) and 87 % [95 % CI: 80 %-94 %] (85/98) for R1 and 79 % [95 % CI: 65 %-94 %] (23/29), 97 % [95 % CI: 93 %-100 %] (67/69), 92 % [95 % CI: 81 %-100 %] (23/25), 92 % [95 % CI: 86 %-98 %] (67/73) and 92 % [95 % CI: 86 %-97 %] (90/98) for R2. Sensitivities for tumour detection were higher after adding DWI to standard MRI, although only for R1 was this significant (P = 0.03). Adding DWI to standard + gadolinium-enhanced MRI did not significantly increase MR performance.
  
  
  CONCLUSIONS
  DWI improves MSBT detection via MR-enterography compared to standard unenhanced MR-enterography, especially for unexperienced readers.
  
  
  CONCLUSIONS
  • MR-enterography is accurate for the detection of mesenteric small-bowel tumours. • Diffusion-weighted sequencing helps inexperienced readers detect small-bowel tumours with MR-enterography. • Diffusion-weighted sequencing adds value to standard MR-enterography when gadolinium is contraindicated.
authors.affiliation: Department of Radiology, Hôpital Robert Debré, Avenue du Général Koenig, 51092, Reims Cedex, France, elisa.amzallag@gmail.com.
authors.forename: Elisa
authors.initials: E
authors.lastname: Amzallag-Bellenger
authors.forename: Philippe
authors.initials: P
authors.lastname: Soyer
authors.forename: Coralie
authors.initials: C
authors.lastname: Barbe
authors.forename: Truong Luong Francis
authors.initials: TL
authors.lastname: Nguyen
authors.forename: Nedjoua
authors.initials: N
authors.lastname: Amara
authors.forename: Christine
authors.initials: C
authors.lastname: Hoeffel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis*; D007421:Intestine, Small / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008643:Mesentery; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
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