title: Diffusion-weighted MR enterography for evaluating Crohn's disease: Effect of anti-peristaltic agent on the diagnosis of bowel inflammation.
abstract: OBJECTIVE
  To prospectively investigate how Buscopan affects the diagnosis of bowel inflammation by diffusion-weighted imaging MR enterography (DWI-MRE) in Crohn's disease (CD).
  
  
  METHODS
  Thirty CD patients without previous bowel surgery underwent DWI-MRE (b = 900 sec/mm2) before and after intravenous Buscopan. The 30 patients were randomly divided into two groups; using a crossover design, interpretations were made regarding the presence of restricted mural diffusion (i.e., bowel inflammation) in nine bowel segments in two separate reading sessions by two readers. The readers also judged restricted mural diffusion extent in each bowel segment on two side-by-side DWI-MRE images with a random right-to-left order. Ileocolonoscopy and conventional MRE interpreted by an expert panel were reference standards.
  
  
  RESULTS
  We analyzed 262 bowel segments. DWI-MRE without Buscopan significantly decreased sensitivity for both readers (58.8 % vs. 72.9 %, P = 0.046; 57.6 % vs. 85.9 %, P = 0.001) and did not significantly increase specificity (P = 0.085 and 0.396). Two readers noted that 28.6 % and 23.3 % of 262 bowel segments had greater diffusion restriction extent on DWI-MRE with Buscopan compared with DWI-MRE without Buscopan (P < 0.001) and 68.7 % and 74 %, respectively, had similar extent between them.
  
  
  CONCLUSIONS
  Omitting Buscopan caused a greater loss in sensitivity of DWI-MRE than false-positive reduction for diagnosing bowel inflammation in CD.
  
  
  CONCLUSIONS
  • Omitting Buscopan significantly decreases DWI-MRE sensitivity for diagnosing bowel inflammation in CD. • Increase in the corresponding DWI-MRE specificity by omitting Buscopan is less apparent. • DWI-MRE without Buscopan underestimates the extent of bowel inflammation in CD.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.|Department of Radiology, Gil Medical Center, Gachon University, 21, Namdong-daero 777beon-gil, Namdong-gu, Incheon, South Korea.
authors.forename: So Hyun
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
authors.forename: Jimi
authors.initials: J
authors.lastname: Huh
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. parksh.radiology@gmail.com.
authors.forename: Seong Ho
authors.identifier: http://orcid.org/0000-0002-1257-8315
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
authors.forename: Seung Soo
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
authors.forename: Ah Young
authors.initials: AY
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
mesh_terms: D000328:Adult; D002086:Butylscopolammonium Bromide / Q000008:administration & dosage*; D003424:Crohn Disease / Q000175:diagnosis*; D018592:Cross-Over Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods / Q000592:standards; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010276:Parasympatholytics / Q000008:administration & dosage*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D010276:Parasympatholytics; D002086:Butylscopolammonium Bromide
keywords: Butylscopolammonium Bromide; Crohn disease; Diffusion Magnetic Resonance Imaging; Magnetic Resonance Imaging; Parasympatholytics