title: Utility of the diffusion-weighted imaging for activity evaluation in Crohn's disease patients underwent magnetic resonance enterography.
abstract: BACKGROUND
  Cross-sectional imaging techniques as magnetic resonance enterography (MRE) may offer additional information on transmural inflammation, stricturing and fistulising complications in Crohn's disease (CD). The purpose of our study was to evaluate the diagnostic accuracy of Magnetic Resonance Imaging (MRI) combined with Diffusion-weighted Imaging (DWI) and MRE for determination of inflammation in small bowel CD.
  
  
  METHODS
  MR imaging examination was performed with a GE Signa EXCITE 3.0 T MRI scanner. The optimal b value in DWI with a learning cohort of patients was determined. The diagnostic accuracy for active lesions and disease activity were accessed by MRE combined with DWI.
  
  
  RESULTS
  The b value 800 s/mm(2) group showed the highest diagnostic sensitivity (74.19%) for diagnostic assessment of active Crohn's lesions on DWI. MRE combined with DWI showed the highest sensitivity (93.55%), specificity (89.47%) and diagnostic accuracy (92%) compared with MRE or DWI alone. The segmental MR score (MR-score-S) showed a significantly positive correlation with the Capsule Endoscopy Crohn's Disease Activity Index Score (CECDAI-S) (r = 0.717, p < 0.01). The total MR score (MR-score-T) showed significant association with C-reactive protein (CRP) (r = 0.445, p = 0.019) and erythrocyte sedimentation rate (ESR) (r = 0.688, p < 0.01).
  
  
  CONCLUSIONS
  MRE combined with DWI improves the diagnostic accuracy for active lesions and correlates the endoscopic disease activity. MRE with DWI could represent a non-invasive tool in assessing active inflammation in CD.
authors: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. fengqi_med@126.com.
authors: Feng
authors: F
authors: Qi
authors: Shanghai Institute of Digestive Disease, Shanghai Inflammatory Bowel Disease Research Center, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. shenjun@vip.163.com.
authors: Shen
authors: S
authors: Jun
authors: Shanghai Institute of Digestive Disease, Shanghai Inflammatory Bowel Disease Research Center, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. medqyq@gmail.com.
authors: Qiao Yu
authors: QY
authors: Qi
authors: Shanghai Institute of Digestive Disease, Shanghai Inflammatory Bowel Disease Research Center, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. pengjc0526@163.com.
authors: Peng Jiang
authors: PJ
authors: Chen
authors: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. gengxiaochuan1949@126.com.
authors: Geng Xiao
authors: GX
authors: Chuan
authors: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. billzhu49@hotmail.com.
authors: Zhu
authors: Z
authors: Jiong
authors: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. xujianrong@renji.com.
authors: Xu Jian
authors: XJ
authors: Rong
mesh_terms: D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D002097:C-Reactive Protein / Q000378:metabolism; D053704:Capsule Endoscopy; D003424:Crohn Disease / Q000097:blood / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D012372:ROC Curve; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
references: Eur J Radiol. 2012 Sep;81(9):2080-8
references: 21924572
references: Abdom Imaging. 2009 Mar-Apr;34(2):141-8
references: 18214582
references: Radiographics. 2009 Oct;29(6):1811-25
references: 19959523
references: Am J Gastroenterol. 2005 Nov;100(11):2493-502
references: 16279905
references: Endoscopy. 2009 Jul;41(7):618-37
references: 19588292
references: AJR Am J Roentgenol. 2007 Nov;189(5):1015-22
references: 17954634
references: J Magn Reson Imaging. 2008 Nov;28(5):1133-40
references: 18972354
references: Gut. 2010 Aug;59(8):1056-65
references: 20525970
references: Pediatr Radiol. 2013 Sep;43(9):1077-85
references: 23949929
references: Radiology. 2011 Apr;259(1):127-35
references: 21324841
references: J Magn Reson Imaging. 2009 Apr;29(4):880-6
references: 19306416
references: Gut. 2009 Aug;58(8):1113-20
references: 19136510
references: Dig Liver Dis. 2013 Dec;45(12):978-85
references: 24018244
references: Gut. 2005 Feb;54(2):257-63
references: 15647191
references: Abdom Imaging. 2010 Dec;35(6):646-53
references: 20509025
references: Eur J Radiol. 2010 Sep;75(3):376-83
references: 19497694
references: Gastroenterology. 2002 Feb;122(2):512-30
references: 11832465
references: Insights Imaging. 2012 Jun;3(3):251-63
references: 22696087
references: AJR Am J Roentgenol. 2011 Jul;197(1):80-5
references: 21701014
references: Inflamm Bowel Dis. 2012 May;18(5):849-56
references: 21710535
references: Gastrointest Endosc. 2004 Oct;60(4):505-12
references: 15472670
references: Radiology. 2006 Feb;238(2):517-30
references: 16371574
references: Inflamm Bowel Dis. 2011 Aug;17(8):1759-68
references: 21744431
references: Radiology. 2002 Mar;222(3):652-60
references: 11867781
references: Aliment Pharmacol Ther. 2011 Jul;34(2):125-45
references: 21615440
references: Aliment Pharmacol Ther. 2013 Mar;37(5):537-45
references: 23289713
references: Inflamm Bowel Dis. 2009 Oct;15(10):1607-8
references: 19291779
references: Pediatr Radiol. 2013 Jan;43(1):103-14
references: 23212595
references: Eur J Radiol. 2009 Mar;69(3):393-7
references: 19118968