title: Prospective evaluation of free-breathing diffusion-weighted imaging for the detection of inflammatory bowel disease with MR enterography in childhood population.
abstract: OBJECTIVE
  To evaluate prospectively the performance of diffusion-weighted imaging (DWI) for the detection of active lesions on MR enterography (MRE) in children with inflammatory bowel disease (IBD).
  
  
  METHODS
  MRE of 48 children (mean age 13 years) with suspected or known IBD were blindly analysed by 2 independent readers for the presence of active lesions. Two sets of imaging including DWI and gadolinium-enhanced imaging (GEI) were reviewed. A reader consensus was obtained. The gold standard was histopathological findings. In patient-level analysis and segment-level analysis, sensitivity and specificity were calculated for DWI and GEI and compared using McNemar's test or logistic random-effects models.
  
  
  RESULTS
  At least 1 active lesion was confirmed in 42 (87.5%) children. Sensitivity and specificity for the detection of at least one lesion were 88.1% (95% CI, 74.3-96.1) and 83.3% (95% CI, 35.9-99.6), respectively, for DWI and 66.7% (95% CI, 50.4-80.4) and 83.3% (95% CI, 35.9-99.6), respectively, for GEI. In segment-level analysis, sensitivity and specificity for the detection of specific segment lesions were 62.5% (95% CI, 48.1-75) and 97.1% (95% CI, 93.5-98.7), respectively, for DWI and 45.7% (95% CI, 30.8-61.3) and 98.2% (95% CI, 95.3-99.4), respectively, for GEI. The sensitivity of DWI was significantly better than that of GEI per patient (p = 0.004) and per segment (p = 0.028).
  
  
  CONCLUSIONS
  DWI demonstrates better performance than GEI for the detection of active lesions in children with IBD.
  
  
  CONCLUSIONS
  Examination with no intravenous injection-DWI can replace T1 weighted images when paediatric patients are screened with MRE for IBD. Examination performed in free breathing is better tolerated by children.
authors.affiliation: 1 Department of Pediatric Radiology, Hospital Jeanne de Flandre, CHRU Lille, Lille Cedex, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Dubron
authors.affiliation: 1 Department of Pediatric Radiology, Hospital Jeanne de Flandre, CHRU Lille, Lille Cedex, France.
authors.forename: Freddy
authors.initials: F
authors.lastname: Avni
authors.affiliation: 1 Department of Pediatric Radiology, Hospital Jeanne de Flandre, CHRU Lille, Lille Cedex, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boutry
authors.affiliation: 2 Department of Pediatric Gastrology, Hospital Jeanne de Flandre, CHRU Lille, Lille Cedex, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Turck
authors.affiliation: 3 Department of Statistics, CHRU Lille, Lille Cedex, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.affiliation: 1 Department of Pediatric Radiology, Hospital Jeanne de Flandre, CHRU Lille, Lille Cedex, France.
authors.forename: Elisa
authors.initials: E
authors.lastname: Amzallag-Bellenger
mesh_terms: D000293:Adolescent; D002648:Child; D003093:Colitis, Ulcerative / Q000175:diagnosis*; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005682:Gadolinium; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012119:Respiration
chemical_list: D003287:Contrast Media; D005682:Gadolinium
references.citation: AJR Am J Roentgenol. 2011 Jun;196(6):W810-6
references.pmid: 21606274
references.citation: J Pediatr Gastroenterol Nutr. 2007 May;44(5):653-74
references.pmid: 17460505
references.citation: J Pediatr. 2005 Jan;146(1):35-40
references.pmid: 15644819
references.citation: Radiology. 2007 Dec;245(3):848-54
references.pmid: 17951348
references.citation: J Pediatr Gastroenterol Nutr. 2005 Jul;41(1):1-7
references.pmid: 15990620
references.citation: Inflamm Bowel Dis. 2015 Jan;21(1):101-9
references.pmid: 25358063
references.citation: J Pediatr Gastroenterol Nutr. 2010 Jan;50(1):27-31
references.pmid: 19934770
references.citation: Acad Radiol. 2009 May;16(5):597-603
references.pmid: 19282206
references.citation: World J Gastroenterol. 2011 Feb 28;17(8):1018-25
references.pmid: 21448353
references.citation: Radiology. 2011 Oct;261(1):12-29
references.pmid: 21931139
references.citation: Eur J Radiol. 2009 Mar;69(3):418-24
references.pmid: 19144484
references.citation: Radiology. 2012 Dec;265(3):910-6
references.pmid: 23093680
references.citation: Pediatr Radiol. 2013 Sep;43(9):1077-85
references.pmid: 23949929
references.citation: Pediatr Radiol. 2011 Dec;41(12):1552-8
references.pmid: 21785852
references.citation: Aliment Pharmacol Ther. 2011 May;33(10):1133-42
references.pmid: 21488915
references.citation: Radiology. 2015 Jan;274(1):29-43
references.pmid: 25531478
references.citation: Pediatr Radiol. 2007 Nov;37(11):1071-82
references.pmid: 17899062
references.citation: J Magn Reson Imaging. 2009 Apr;29(4):880-6
references.pmid: 19306416
references.citation: J Magn Reson Imaging. 2011 Mar;33(3):615-24
references.pmid: 21563245
references.citation: Radiographics. 2014 May-Jun;34(3):E73-88
references.pmid: 24819803
references.citation: Radiology. 2012 Aug;264(2):333-48
references.pmid: 22821694
references.citation: Am J Gastroenterol. 2015 Mar;110(3):432-40
references.pmid: 25623654
references.citation: Gastroenterology. 2004 May;126(6):1504-17
references.pmid: 15168363
references.citation: Pediatrics. 2008 Nov;122 Suppl 3:S130-3
references.pmid: 18978006
references.citation: AJR Am J Roentgenol. 2012 Oct;199(4):907-15
references.pmid: 22997386
references.citation: J Crohns Colitis. 2010 Feb;4(1):7-27
references.pmid: 21122488
references.citation: AJR Am J Roentgenol. 2011 Jul;197(1):224-31
references.pmid: 21701034
references.citation: Insights Imaging. 2012 Jun;3(3):251-63
references.pmid: 22696087
references.citation: Eur Radiol. 2014 Nov;24(11):2916-26
references.pmid: 25113647
references.citation: Radiology. 2016 Mar;278(3):762-72
references.pmid: 26348103
references.citation: AJR Am J Roentgenol. 2008 Aug;191(2):502-6
references.pmid: 18647923
references.citation: Eur Radiol. 2014 Mar;24(3):619-29
references.pmid: 24037299
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571
references.citation: Aliment Pharmacol Ther. 2013 Mar;37(5):537-45
references.pmid: 23289713
references.citation: Pediatr Radiol. 2014 Jul;44(7):821-30
references.pmid: 24584271
references.citation: Pediatr Radiol. 2016 Jan;46(1):34-42
references.pmid: 26238966
references.citation: Gastroenterol Res Pract. 2013;2013:829040
references.pmid: 24454343
references.citation: Pediatr Radiol. 2013 Jan;43(1):103-14
references.pmid: 23212595