Diffusion-weighted imaging and apparent diffusion coefficient values for evaluating terminal ileitis in patients with...

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Crohn's disease frequently affects the terminal ileum, causing inflammation (terminal ileitis).
• Accurate diagnosis of active inflammation is crucial for effective Crohn's disease management.
• Non-invasive imaging techniques are valuable for assessing disease activity.

Purpose of the Study:

• To evaluate the diagnostic accuracy of diffusion-weighted imaging (DWI) for terminal ileitis in Crohn's disease patients.
• To correlate DWI findings with established clinical and endoscopic measures of inflammation.

Main Methods:

• Retrospective analysis of 38 Crohn's disease patients undergoing MRI enterography with DWI.
• Patients categorized into active inflammation or inactive disease groups based on colonoscopy and biopsy.
• Measurement of apparent diffusion coefficient (ADC) values, MaRIA, and Clermont scores.

Main Results:

• DWI demonstrated high accuracy (89.4%) in detecting terminal ileitis.
• Active inflammation showed significantly restricted diffusion (lower ADC values), increased wall thickening, and higher MaRIA/Clermont scores.
• Optimal ADC cut-off of 2.1 × 10^-3 mm²/s yielded 88.8% sensitivity and 95.0% specificity for inflammation.

Conclusions:

• Visual DWI analysis is accurate for detecting terminal ileitis in Crohn's disease.
• Low ADC values are sensitive indicators of colonoscopy-proven inflammation, supporting DWI's role in disease assessment.