1. Can diffusion weighting replace gadolinium enhancement in magnetic resonance enterography for inflammatory bowel disease in children?
- Author
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Khachab F, Loundou A, Roman C, Colavolpe N, Aschero A, Bourlière-Najean B, Daidj N, Desvignes C, Pico H, Gorincour G, Auquier P, and Petit P
- Subjects
- Adolescent, Child, Child, Preschool, Colonoscopy, Female, Humans, Male, Predictive Value of Tests, Sensitivity and Specificity, Contrast Media administration & dosage, Diffusion Magnetic Resonance Imaging, Gadolinium administration & dosage, Image Enhancement methods, Inflammatory Bowel Diseases diagnostic imaging
- Abstract
Background: Contrast-enhanced MRI is often used for diagnosis and follow-up of children with inflammatory bowel disease., Objective: To compare the accuracy of diffusion-weighted MRI (DWI) to contrast-enhanced MRI in children with known or suspected inflammatory bowel disease., Materials and Methods: This retrospective, consecutive study included 55 children. We used ileo-colonoscopy and histology as the reference standard from the terminal ileum to the rectum, and contrast-enhanced MRI as the reference standard proximal to the terminal ileum. DWI and contrast-enhanced MRI sequences were independently reviewed and compared per patient and per segment to these reference standards and to the follow-up for each child., Results: We obtained endoscopic data for 340/385 colonic and ileal segments (88%). The rate of agreement per segment between DWI and endoscopy was 64%, and the rate of agreement between contrast-enhanced MRI and endoscopy was 59%. Per patient, sensitivity and specificity of bowel wall abnormalities as compared to the endoscopy were 87% and 100% for DWI, and 70% and 100% for contrast-enhanced MRI, respectively. Positive and negative predictive values were, respectively, 100% and 57% for DWI, and 96% and 41% for contrast-enhanced MRI. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of DWI compare to contrast-enhanced MRI in the segments proximal to the terminal ileum were 90%, 98%, 90%, 98% and 96%, respectively., Conclusion: The diagnostic performance of DWI is competitive to that of contrast-enhanced MRI in children with known or suspected inflammatory bowel disease.
- Published
- 2018
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