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Published on: December 15, 2017
MR motility imaging in Crohn's disease improves lesion detection compared with standard MR imaging
Johannes M Froehlich1, Christian Waldherr, Christoforos Stoupis
1Institute of Diagnostic, Interventional and Pediatric, Radiology, Inselspital, University Hospital, Bern, Switzerland.
Objective:
To evaluate retrospectively in patients with Crohn's disease (CD) if magnetic resonance (MR) motility alterations correlate with CD typical lesions leading to an increased detection rate.
Methods:
Forty patients with histologically proven CD underwent MR enterography (MRE), including coronal cine sequences (cine MRE), in addition to the standard CD MR protocol. Two blinded readings were performed with and without cine MRE. Locations presenting motility alterations on the cine sequences were analysed on standard MRE for CD-related lesions. This was compared with a second reading using the standard clinical MRE protocol alone.
Results:
The number of lesions localised by cine MRE and identified on standard MRE compared with standard MRE alone were 35/24 for wall thickening (p = 0.002), 24/20 for stenoses (p = 0.05), 17/11 for wall layering (p = 0.02), 5/3 for mucosal ulcers (p = 0.02) and 21/17 for the comb sign (p = 0.05). Overall, cine MRE detected 35 more CD-specific findings than standard MRE alone (124/89; p = 0.007) and significantly more patients with CD-relevant MR findings (34/28; p = 0.03).
Conclusion:
CD lesions seem to be associated with motility changes and this leads to an increased lesion detection rate compared with standard-MRE imaging alone.
Insights
Magnetic resonance (MR) motility alterations in Crohn's disease (CD) correlate with lesions, significantly increasing detection rates. Cine MR enterography (MRE) enhances identification of CD-specific findings compared to standard MRE alone.
Area of Science:
- Gastroenterology
- Radiology
- Medical Imaging
Background:
- Crohn's disease (CD) diagnosis relies on imaging, but subtle lesions can be missed.
- Standard MR enterography (MRE) protocols may not fully capture dynamic disease activity.
Purpose of the Study:
- To assess if MR motility alterations correlate with CD lesions.
- To determine if incorporating cine sequences in MRE improves CD lesion detection rates.
Main Methods:
- Retrospective analysis of 40 patients with CD.
- Comparison of two blinded readings: standard MRE vs. MRE with cine sequences.
- Analysis of motility alterations on cine sequences and their correlation with CD lesions on standard MRE.
Main Results:
- Cine MRE significantly increased detection of wall thickening (35/24), stenoses (24/20), wall layering (17/11), ulcers (5/3), and the comb sign (21/17).
- Overall, cine MRE identified 35 more CD-specific findings (124/89) and more patients with CD-relevant findings (34/28) compared to standard MRE alone.
Conclusions:
- Motility changes observed on cine MRE are associated with CD lesions.
- Integrating cine sequences into MRE protocols enhances the detection rate of CD-specific findings.
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