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Updated: May 27, 2025
Diffusion Imaging in the Rat Cervical Spinal Cord
Published on: April 7, 2015
Exploratory high b value diffusion-weighted MR for quantitative differentiation of ileocecal inflammatory conditions
Hao Yu1, Yucheng Hai2, Jingyu Lu2
1Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China. zn003969@whu.edu.cn.
Insights
High b value diffusion-weighted imaging (DWI) effectively differentiates ileocecal tumors from inflammatory conditions. Signal intensity ratio (SIR) from high b value DWI shows the most promise for non-invasive diagnosis.
Area of Science:
- Radiology and Medical Imaging
- Oncology
- Gastroenterology
Background:
- Distinguishing between ileocecal inflammatory conditions and tumors is clinically challenging.
- Conventional diffusion-weighted imaging (DWI) has limitations in differentiating these pathologies.
Purpose of the Study:
- To evaluate the quantitative analysis of high b value (2000 s/mm² ) DWI for differentiating ileocecal inflammatory conditions and tumors.
- To compare the diagnostic performance of high b value DWI with conventional b value (800 s/mm² ) DWI.
Main Methods:
- MR enterography with conventional and high b values DWI was performed on 66 patients.
- Quantitative apparent diffusion coefficient (ADC) values and signal intensity ratios (SIRs) were measured.
- Receiver operating characteristic (ROC) curve analysis was used to assess diagnostic performance.
Main Results:
- Tumors showed significantly lower ADC values and higher SIR values compared to inflammatory conditions at both b values.
- High b value DWI yielded superior areas under the curve (AUC) for both ADC (0.828) and SIR (0.947) compared to conventional DWI.
- SIR values demonstrated better diagnostic performance than ADC values for both b values.
Conclusions:
- Quantitative ADC values and SIR derived from DWI are non-invasive tools for differentiating ileocecal tumors from inflammatory conditions.
- High b value DWI significantly improves the differentiation accuracy.
- SIR from high b value DWI is the most promising quantitative parameter for this diagnostic task.
Objectives:
To explore the quantitative analysis of high b value (2000 s/mm2) diffusion-weighted imaging (DWI) for the differentiation of ileocecal inflammatory conditions and tumors, compared with conventional b value (800 s/mm2) DWI.
Methods:
Sixty-six patients with 30 tumors and 36 inflammatory conditions underwent MR enterography with conventional and high b values DWI. Quantitative apparent diffusion coefficient (ADC) values and signal intensity ratios (SIRs) of lesions of the psoas muscle were measured from the two b value DWIs. The receiver operating characteristic (ROC) curve was applied to determine the diagnostic value of ADC and SIR for differentiating tumors from inflammatory conditions.
Results:
The ADC values of tumors were significantly lower than those of inflammatory conditions in 800 s/mm2 (p = 0.001) and 2000 s/mm2 (p < 0.001) DWI. In addition, tumors exhibited significantly higher SIR values compared to inflammatory conditions (p < 0.001 in 800 s/mm2 and 2000 s/mm2 DWI). Areas under the curve (AUC) of ADC and SIR derived from high b value (0.828 for ADC, 0.947 for SIR) were superior to those from conventional b value DWI (0.731 and 0.849, respectively). Compared to ADC, SIR values achieved better AUCs in both two b values DWI.
Conclusions:
Quantitative ADC values and SIR could be used as non-invasive tools to distinguish ileocecal tumors from inflammatory conditions. The use of high b value DWI would improve this ability. Furthermore, SIR obtained from high b value DWI was the most promising quantitative parameter.
Critical Relevance Statement:
This study indicated that quantitative DWI parameters might be applied as non-invasive imaging biomarkers for distinguishing bowel tumors from inflammatory conditions. The SIR from high b value DWI could improve the differentiation, providing invaluable information for establishing appropriate therapeutic strategies.
Key Points:
Differentiation between bowel inflammatory conditions and tumors is still a dilemma. Quantitative DWI contributed to distinguishing ileocecal tumors from inflammatory conditions. SIR from DWI is a promising parameter for differentiating these pathologies.
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