New magnetic resonance imaging sequences for fibrosis assessment in Crohn's disease: a pilot study

Patients with Crohn's disease can develop intestinal strictures, containing various degrees of inflammation and fibrosis. Differentiation of the main component of a structuring lesion is the key for defining the therapeutic management. We evaluated new magnetic resonance imaging sequences (IVIM (Intravoxel Incoherent Motion imaging) and T1 mapping) for assessing fibrosis in Crohn's disease.

This was a prospective, single-center study of adult patients with Crohn's disease and magnetic resonance imaging examination, including IVIM and T1 mapping sequences, between March 2021 and April 2021. The association between the perfusion fraction (IVIM), reduction of relaxation time between pre- and postcontrast enhancement (T1 mapping), and the degree of fibrosis assessed by a visual analog scale from 0 to 10 was evaluated.

A total of 33 patients were included. The perfusion fraction was significantly correlated with fibrosis, with lower perfusion fraction in severe fibrosis (p = .002). T1 mapping sequence was also correlated with the degree of fibrosis, reduction of relaxation time was higher in patients with severe fibrosis than in patients with mild fibrosis (p = .05).

In Crohn's disease, these new tools could improve the performance of magnetic resonance imaging for transmural fibrosis quantification, and may be useful for improving care.