title: Crohn's disease of the small bowel: evaluation of ileal inflammation by diffusion-weighted MR imaging and correlation with the Harvey-Bradshaw index.
abstract: OBJECTIVE
  This study was undertaken to determine the diagnostic capabilities of diffusion-weighted magnetic resonance imaging (DWI) in detecting ileal inflammation in Crohn's disease (CD), and to verify the correlation between the DWI sequences and the Harvey-Bradshaw index (HBI).
  
  
  METHODS
  Twenty patients with an endoscopic-histological diagnosis of CD of the terminal ileum and MR enterography with DWI sequences and HBI were retrospectively selected. Disease activity was visually evaluated on the DWI sequences. In quantitative analysis, the apparent diffusion coefficient (ADC) of the terminal ileum was compared with that of normal ileal loops. Pearson's r was used to verify the correlation between the DWI findings and the HBI.
  
  
  RESULTS
  On visual assessment, the accuracy, sensitivity and positive predictive value of DWI for the detection of inflammation were 100%. In the quantitative assessment, the ADC value of the disease-active terminal ileum was significantly lower (p < 0.00001) than that of normal ileal loops. A correlation was found between visual assessment of the terminal ileum with the DWI sequences and HBI; no correlation was found between ADC of the terminal ileum and HBI.
  
  
  CONCLUSIONS
  DWI sequences may be useful in differentiating actively inflamed small bowel segments from normal small bowel in CD. Though partial, the correlation between DWI sequences and HBI confirms the utility of this technique in the study of patients with CD.
authors: Dipartimento Specialità Medico-Chirurgiche, Sezione di Scienze Radiologiche, Università di Catania, Via Santa Sofia 78, 95123, Catania, Italy, pietrofoti@hotmail.com.
authors: Pietro Valerio
authors: PV
authors: Foti
authors: Renato
authors: R
authors: Farina
authors: Maria
authors: M
authors: Coronella
authors: Stefano
authors: S
authors: Palmucci
authors: Noemi
authors: N
authors: Ognibene
authors: Pietro
authors: P
authors: Milone
authors: Cristina
authors: C
authors: Conti Bellocchi
authors: Leonardo
authors: L
authors: Samperi
authors: Gaetano
authors: G
authors: Inserra
authors: Andrea
authors: A
authors: Laghi
authors: Giovanni Carlo
authors: GC
authors: Ettorre
mesh_terms: D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000150:complications*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007079:Ileitis / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018434:Sickness Impact Profile; D055815:Young Adult
references: Gut. 2006 Mar;55 Suppl 1:i1-15
references: 16481628
references: Acad Radiol. 2009 May;16(5):597-603
references: 19282206
references: Am J Gastroenterol. 2014 Jan;109(1):89-98
references: 24247212
references: Gut. 2010 Aug;59(8):1056-65
references: 20525970
references: Radiology. 2009 Mar;250(3):784-92
references: 19244045
references: Radiol Med. 2012 Mar;117(2):268-81
references: 22271005
references: Eur J Radiol. 2009 Mar;69(3):418-24
references: 19144484
references: Pediatr Radiol. 2013 Sep;43(9):1077-85
references: 23949929
references: JBR-BTR. 2002 Apr-May;85(2):100-3
references: 12083620
references: J Magn Reson Imaging. 2009 Apr;29(4):880-6
references: 19306416
references: J Magn Reson Imaging. 2011 Mar;33(3):615-24
references: 21563245
references: Neuroradiology. 2006 Dec;48(12):875-80
references: 16944118
references: Magn Reson Imaging Clin N Am. 2005 May;13(2):331-48
references: 15935315
references: Radiol Med. 2008 Mar;113(2):199-213
references: 18386122
references: Gut. 2003 Mar;52(3):393-7
references: 12584222
references: Radiol Med. 2006 Apr;111(3):392-419
references: 16683086
references: Radiol Med. 2011 Aug;116(5):720-33
references: 21293944
references: AJR Am J Roentgenol. 2008 Feb;190(2):481-8
references: 18212236
references: Radiol Med. 2009 Jun;114(4):645-59
references: 19430732
references: J Magn Reson Imaging. 2008 Jul;28(1):89-95
references: 18581382
references: Top Magn Reson Imaging. 2002 Dec;13(6):389-96
references: 12478019
references: Radiol Med. 2011 Aug;116(5):766-80
references: 21424319
references: Inflamm Bowel Dis. 2011 Aug;17(8):1759-68
references: 21744431
references: Radiol Med. 2003 Jul-Aug;106(1-2):18-27
references: 12951547
references: Abdom Imaging. 2000 May-Jun;25(3):219-28
references: 10823437
references: Transplant Proc. 2012 Sep;44(7):1884-8
references: 22974862
references: Aliment Pharmacol Ther. 2013 Mar;37(5):537-45
references: 23289713
references: Eur Radiol. 2010 Mar;20(3):754-62
references: 19727740
references: Lancet. 1980 Mar 8;1(8167):514
references: 6102236
references: Inflamm Bowel Dis. 2006 Apr;12(4):304-10
references: 16633052