Celiac disease: evaluation with dynamic contrast-enhanced MR imaging

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Celiac disease is an autoimmune disorder triggered by gluten ingestion, leading to small intestine inflammation.
• Accurate assessment of active inflammation in celiac disease is crucial for monitoring treatment efficacy.

Purpose of the Study:

• To prospectively evaluate duodenal mural perfusion dynamics using dynamic contrast-enhanced MRI in untreated celiac disease patients.
• To compare these perfusion dynamics with those in treated celiac disease patients and healthy controls.

Main Methods:

• Dynamic contrast-enhanced MRI was performed on 60 untreated celiac disease patients, 45 treated patients, and 30 controls.
• Perfusion parameters including maximum enhancement and enhancement slope were calculated for the descending duodenal wall.
• Duodenal wall thickness was also assessed and statistically analyzed.

Main Results:

• Untreated celiac disease patients exhibited significantly higher mean maximum duodenal wall enhancement (229.1 ± 46.4) compared to treated patients (109.8 ± 27.8) and controls (94.7 ± 17.9) (P < .001).
• Time-signal intensity curves showed fast enhancement and washout (type 4) in all untreated patients, versus slow constant enhancement (type 2) in treated patients and controls.
• No significant difference in mean duodenal wall thickness was observed among the three groups.

Conclusions:

• Dynamic contrast-enhanced MRI effectively demonstrates increased mural perfusion in active celiac disease.
• This imaging technique offers a reproducible method for assessing the inflammatory state in celiac disease.