High b-value computed diffusion-weighted imaging for differentiating bowel inflammation in Crohn's disease
High b-value computed diffusion-weighted imaging for differentiating bowel inflammation in Crohn's disease
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DOI：
10.1016/j.ejrad.2020.109362
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发表时间：
2020-12-01
影响因子：
3.3
通讯作者：
Tateisi, Ukihide
中科院分区：
文献类型：
--
作者：
Kitazume, Yoshio;Tsuchiya, Junichi;Tateisi, Ukihide
目的探讨高b值计算机弥散加权成像（cDWI）对克罗恩病（CD）患者肠道炎症的诊断价值。方法回顾性分析54例接受磁共振小肠造影（MRE）、回结肠镜（ICS）或气囊辅助小肠镜（BAE）检查的CD患者。使用b值为0和800 s/mm（2）（aDWI 800）采集的DWI生成B值= 1500 s/mm（2）（cDWI 1500）的cDWI。总共评价了366个肠段。在DWI上视觉评估肠腔的信号强度（SI）。测量aDWI 800和cDWI 1500图像上的肠壁-髂腰肌SI比值和表观扩散系数（ADC）值;使用5点Likert样量表对aDWI 800的MRE平扫、cDWI 1500的MRE平扫和无DWI的对比增强（CE）-MRE进行病变检测的目视评估。结果在aDWI 800和cDWI 1500的351个节段中，分别有157个节段（44.7%）和345个节段（98.3%）的管腔内液体的SI与背景SI相当或低于背景SI。cDWI 1500图像上SI比率的AUC（82.0%，[95%置信区间：76.6- 87.3%]）大于aDWI 800（75.2%，[68.2- 82.3%]; p < 0.001），并且接近ADC值（81.5%[76.3- 86.7%]; p = 0.76）。CE-MRE图像的AUC最大，其次是cDWI 1500的MRE平扫图像，aDWI 800的MRE平扫图像。结论cDWI 1500能抑制腔内液体的SI，改善严重炎症与非严重炎症的对比度，有助于CD的评价。
Purpose This study evaluated whether high b-value computed diffusion-weighted imaging (cDWI) can improve detection and differentiation of bowel inflammation in patients with Crohn's disease (CD).Methods Fifty-four consecutive CD patients who had undergone magnetic resonance enterography (MRE) and ileocolonoscopy (ICS) or balloon-assisted enteroscopy (BAE) were retrospectively studied; cDWI with a b value = 1500s/mm(2) (cDWI1500) was generated using DWI acquired with b-values of 0 and 800 s/mm(2) (aDWI800). Overall, 366 bowel segments were evaluated. The signal intensities (SIs) of the bowel lumina were visually assessed on DWI. Bowel wall-to-iliopsoas muscle SI ratios on aDWI800 and cDWI1500 images and apparent diffusion coefficient (ADC) values were measured; visual assessments for lesion detection were performed using a 5-point Likert-like scale on plain MRE with aDWI800, plain MRE with cDWI1500, and contrast-enhanced (CE)-MRE without DWI. The area under the receiver-operating characteristic curve (AUC) was calculated to compare quantitative and qualitative assessments.Results SIs of the intraluminal fluid were shown as comparable to, or lower than background SIs on 157 (44.7 %) and 345 (98.3 %) of 351 segments on aDWI800 and cDWI1500, respectively. AUCs of SI ratios on cDWI1500 images (82.0 %, [95 % confidence interval: 76.6-87.3 %]) were greater than on aDWI800 (75.2 %, [68.2-82.3 %]; p < 0.001), and were close to the ADC values (81.5 % [76.3-86.7 %]; p = 0.76). The AUCs of CE-MRE images were largest, followed by plain MRE with cDWI1500, and plain MRE with aDWI800.Conclusions As it suppresses the SIs of intraluminal fluid and improves contrast between severe and non-severe inflammation, cDWI1500 helps with CD evaluation.