title: Diagnostic value of diffusion-weighted imaging (DWI) for the assessment of the small bowel in patients with inflammatory bowel disease.
abstract: OBJECTIVE
  To evaluate diffusion-weighted imaging (DWI) compared to standard magnetic resonance imaging (sMRI) in the assessment of inflammatory lesions of the small bowel.
  
  
  METHODS
  Two readers retrospectively analysed MRI images of the small bowel including DWI followed by capsule endoscopy (CE) and ileocolonoscopy (ICS) in 30 consecutive patients with a suspected or established diagnosis of inflammatory bowel disease. Small bowel CE and the combination of CE + ICS were used as the standards of reference. Inflammatory lesions of the small bowel detected at endoscopy were compared with the findings of (1) sMRI alone (MRI without DWI), (2) DWI alone, and (3) sMRI in combination with DWI (sMRI + DWI). The sensitivity, specificity, and accuracy were calculated for all three readouts. The results of the three readouts were compared with each other.
  
  
  RESULTS
  Using CE + ICS as the standard of reference, the mean sensitivity and specificity for the detection of inflammatory lesions of the small bowel at sMRI were 55.2% and 99.5%, at DWI 60% and 99%, and at sMRI + DWI 70% and 99%. Interobserver agreement between the two readers was very good (k=0.87-0.95). Two lesions in different patients were only detected at DWI.
  
  
  CONCLUSIONS
  DWI of the small bowel not only allowed for the detection of inflammatory lesions with high accuracy, but also enabled the identification of additional lesions that were not found using sMRI alone.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: m.hahnemann@uke.de.
authors.forename: M L
authors.initials: ML
authors.lastname: Hahnemann
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Dechene
authors.affiliation: Department of Pediatrics, University Hospital Essen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Kathemann
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Sirin
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Essen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Gerken
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany.
authors.forename: T C
authors.initials: TC
authors.lastname: Lauenstein
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany; Department of Radiology, Wisconsin Institutes for Medical Research, University of Wisconsin, USA.
authors.forename: S
authors.initials: S
authors.lastname: Kinner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult