Longitudinal diffusion-weighted imaging changes in children with small bowel Crohn's disease: preliminary experience

Area of Science:

• Pediatric gastroenterology
• Radiology
• Medical imaging

Background:

• Crohn's disease (CD) in children can affect the small bowel.
• Diffusion-weighted imaging (DWI) shows restricted diffusion in diseased bowel segments.
• Longitudinal DWI changes in pediatric CD are not well-studied.

Purpose of the Study:

• To track DWI changes in pediatric Crohn's disease small bowel lesions over time.
• To correlate DWI changes with imaging phenotypes and clinical status.

Main Methods:

• Retrospective analysis of serial MRI enterography (MRE) with DWI in pediatric CD patients (<21 years).
• Measured longitudinal changes in mean apparent diffusion coefficient (ADC) values of affected bowel segments.
• Correlated ADC changes with imaging phenotype and clinical disease activity.

Main Results:

• Seventeen lesions in 13 pediatric patients were analyzed.
• Fibrostenotic lesions showed significantly lower ADC change over time compared to non-fibrostenotic lesions.
• Fibrostenotic lesions had lower ADC values than inflammatory, which had lower values than normal bowel.

Conclusions:

• Longitudinal DWI patterns vary in pediatric Crohn's disease lesions based on their progression.
• ADC values may serve as an imaging biomarker for assessing lesion status in pediatric CD.
• ADC changes can help distinguish between inflammation and fibrosis in Crohn's disease lesions.