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Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn’s disease assessment with histopathology of surgical specimens

  • Gastrointestinal
  • Published:
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Abstract

Objectives

To prospectively compare conventional MRI sequences, dynamic contrast enhanced (DCE) MRI and diffusion weighted imaging (DWI) with histopathology of surgical specimens in Crohn’s disease.

Methods

3-T MR enterography was performed in consecutive Crohn’s disease patients scheduled for surgery within 4 weeks. One to four sections of interest per patient were chosen for analysis. Evaluated parameters included mural thickness, T1 ratio, T2 ratio; on DCE-MRI maximum enhancement (ME), initial slope of increase (ISI), time-to-peak (TTP); and on DWI apparent diffusion coefficient (ADC). These were compared with location-matched histopathological grading of inflammation (AIS) and fibrosis (FS) using Spearman correlation, Kruskal–Wallis and Chi-squared tests.

Results

Twenty patients (mean age 38 years, 12 female) were included and 50 sections (35 terminal ileum, 11 ascending colon, 2 transverse colon, 2 descending colon) were matched to AIS and FS. Mural thickness, T1 ratio, T2 ratio, ME and ISI correlated significantly with AIS, with moderate correlation (r = 0.634, 0.392, 0.485, 0.509, 0.525, respectively; all P < 0.05). Mural thickness, T1 ratio, T2 ratio, ME, ISI and ADC correlated significantly with FS (all P < 0.05).

Conclusions

Quantitative parameters from conventional, DCE-MRI and DWI sequences correlate with histopathological scores of surgical specimens. DCE-MRI and DWI parameters provide additional information.

Key points

• Conventional MR enterography can be used to assess Crohn’s disease activity.

• Several MRI parameters correlate with inflammation and fibrosis scores from histopathology.

• Dynamic contrast enhanced imaging and diffusion weighted imaging give additional information.

• Quantitative MRI parameters can be used as biomarkers to evaluate Crohn’s disease activity.

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Abbreviations

ADC:

Apparent diffusion coefficient

CDAI:

Crohn’s disease activity index

CRP:

C-reactive protein

DCE:

Dynamic contrast enhanced

DWI:

Diffusion weighted imaging

ISI:

Initial slope of increase

ME:

Maximum enhancement

ROI:

Region of interest

TTP:

Time-to-peak

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Acknowledgments

A research grant was given by NutsOhra Foundation (Amsterdam, the Netherlands). The NutsOhra Foundation was not involved in designing and conducting this study, did not have access to the data, and was not involved in data analysis or preparation of this manuscript.

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Authors and Affiliations

  1. Academic Medical Center, Department of Radiology, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands

    Jeroen A. W. Tielbeek, Manon L. W. Ziech, Cristina Lavini, Shandra Bipat, Frans M. Vos & Jaap Stoker

  2. Quantitative Imaging Group, Department of Imaging Science and Technology, Delft University of Technology, Delft, The Netherlands

    Zhang Li & Frans M. Vos

  3. Academic Medical Center, Department of Surgery, University of Amsterdam, Amsterdam, The Netherlands

    Willem A. Bemelman

  4. Academic Medical Center, Department of Pathology, University of Amsterdam, Amsterdam, The Netherlands

    Joris J. T. H. Roelofs

  5. Academic Medical Center, Department of Gastroenterology and Hepatology, University of Amsterdam, Amsterdam, The Netherlands

    Cyriel Y. Ponsioen

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  1. Jeroen A. W. Tielbeek
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  2. Manon L. W. Ziech
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  3. Zhang Li
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Correspondence to Jeroen A. W. Tielbeek.

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Tielbeek, J.A.W., Ziech, M.L.W., Li, Z. et al. Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn’s disease assessment with histopathology of surgical specimens. Eur Radiol 24, 619–629 (2014). https://doi.org/10.1007/s00330-013-3015-7

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