The Prediction of Active Crohn’s Disease on Diffusion-Weighted Imaging
Fatma Kulali1* and Kamil Ozdil2
1Associate Professor of Radiology Department, University of Health Sciences Umraniye Training and Research Hospital, Turkey
2Professor of Gastroenterology Department, University of Health Sciences Umraniye Training and Research Hospital, Turkey
*Corresponding Author: Fatma Kulali, Associate Professor of Radiology Department, University of Health Sciences Umraniye Training and Research Hospital, Turkey.
February 08, 2022; Published: March 14, 2022
Purpose: We aimed to investigate the diagnostic performance of diffusion-weighted imaging (DWI) and normalized apparent diffusion coefficient (nADC) in the prediction of active Crohn’s disease.
Methods: A total of 47 patients (21 [45%] women and 26 [55%] men) with a mean age of 40 years were included in this study. Magnetic resonance imaging (MR) and DWI examinations of patients with Crohn’s disease were reviewed. Five intestinal segments were evaluated for simplified MR index of activity (sMaRIA). The estimations of sMaRIA and nADC values were performed for each segment. The diagnostic performances of nADC values and sMaRIA were evaluated for the detection of active Chron’s disease. The relationship between radiological findings and colonoscopy results was analyzed statistically.
Results: Among 235 intestinal segments of 47 patients, there were 76 active inflammatory segments. The nADC values of active inflammatory intestinal segments were lower compared to inactive group’s (p < 0.05). Active disease had lower nADC value. For all segments (n = 235), with a cut off value of nADC ≤ 0.75, the sensitivity, specificity and accuracy ratio was 89.2%, 98.8%, and 95.7%, respectively (AUROC: 0.981). Higher sMaRIA scores were significantly related to lower nADC values (p < 0.05).
Conclusions: The estimation of nADC value with a cut off value ≤ 0.75 is an important predictor for active Crohn’s disease. Especially in patients at high risk for contrast agent administration, nADC value is useful for the detection of disease activity.
Keywords: Crohn’s Disease; Disease Activity; Magnetic Resonance Enterography; Diffusion-Weighted Imaging; Apparent Diffusion Coefficient
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