Contrast-enhanced MR enterography as a stand-alone tool to evaluate Crohn's disease in a paediatric population

Spieler, Benjamin; Hindman, Nicole; Levy, Jonathan M.; Zabrieski, K.; Sahlein, Daniel; Seuss, Claudia R.; Kim, S.

doi:10.1016/j.crad.2013.04.014

Cited by 9 publications

(6 citation statements)

References 28 publications

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“…Moreover, we found that mural T 2 hyperintensity and mural layered enhancement are the best independent predictors of active CD at MRE. Our results confirm previous studies that found that mural enhancement after gadolinium injection is a reliable sign of CD activity . According to the results of our study the evidence of mural T 2 hyperintensity can be considered sufficient to diagnose active CD, without the injection of gadolinium, which can be avoided in most patients.…”

Section: Discussionsupporting

confidence: 91%

“…As a matter of fact, transmural enhancement can represent active transmural inflammation, even though a less intense enhancement is also often seen in chronic disease without acute inflammation with a consequent difficulty to differentiate active from quiescent CD based only on the visual analysis of contrast enhancement. Our results are probably due to the more comparable percentages of patients with active and quiescent CD in our study if compared to previous studies …”

Section: Discussionsupporting

confidence: 71%

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Impact of gadolinium‐based contrast agent in the assessment of Crohn's disease activity: Is contrast agent injection necessary?

Quaia

Sozzi

Gennari

et al. 2015

Magnetic Resonance Imaging

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 71%

Impact of gadolinium‐based contrast agent in the assessment of Crohn's disease activity: Is contrast agent injection necessary?

Quaia

Sozzi

Gennari

et al. 2015

Magnetic Resonance Imaging

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“…Searches of the bibliographies of articles identified 1 additional eligible study . Full-text reviews of 48 potentially eligible articles were performed and 30 articles were excluded for the following reasons: 14 articles with insufficient data to reconstruct 2 × 2 tables, 10 articles that were not in the field of interest, 3 articles that included partially overlapping patient cohorts with other studies, and 3 articles that used clinical settings or imaging modalities other than histopathological findings as a reference standard . Finally, 18 original articles including a total of 687 patients evaluating the diagnostic performance of MR enterography for detection of active inflammation in patients with known or suspected IBD were included in our study …”

Section: Resultsmentioning

confidence: 99%

Diagnostic Performance of Magnetic Resonance Enterography for Detection of Active Inflammation in Children and Adolescents With Inflammatory Bowel Disease

Yoon

Suh²,

Kim

et al. 2017

JAMA Pediatr

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IMPORTANCE Magnetic resonance (MR) enterography has the advantage over other techniques of being noninvasive, lacking ionizing radiation, and demonstrating excellent soft-tissue contrast to evaluate pediatric patients with inflammatory bowel disease (IBD).OBJECTIVE To evaluate the diagnostic performance of MR enterography for detection of active inflammation in children and adolescents with known or suspected IBD.DATA SOURCES A search of MEDLINE and EMBASE up to January 2, 2017, was performed to identify studies. Search terms included child, pediatric, adolescent, Crohn disease, inflammatory bowel disease, and magnetic resonance enterography. The search was limited to English-language publications.STUDY SELECTION Studies evaluating the diagnostic performance of MR enterography for detection of active inflammation in pediatric patients with known or suspected IBD were selected. Two reviewers independently assessed the eligibility of the selected articles. DATA EXTRACTION AND SYNTHESISThe study was performed and reported in accordance with the PRISMA guidelines. Pooled summary estimates of sensitivity and specificity were calculated using hierarchical logistic regression modeling. MAIN OUTCOMES AND MEASURESThe diagnostic performance of MR enterography for detection of active inflammation in pediatric patients with known or suspected IBD was the primary outcome. Subgroup analyses and meta-regression were performed. RESULTSEighteen original articles involving a total of 687 patients were included. The summary sensitivity was 83% (95% CI, 75%-89%), the summary specificity was 93% (95% CI, 90%-95%), and the area under the hierarchical summary receiver operating characteristic curve was 0.95 (95% CI, 0.93-0.97). The Higgins I 2 statistics demonstrated substantial heterogeneity in terms of sensitivity (I 2 = 84.1%) and specificity (I 2 = 68.8%). Based on per-patient analysis, the summary sensitivity was 86% (95% CI, 78%-91%) and specificity was 91% (95% CI, 82%-96%). In meta-regression, among the various potential covariates, scanner manufacturer was associated with study heterogeneity.CONCLUSIONS AND RELEVANCE Magnetic resonance enterography, which is a noninvasive, radiation-free modality, demonstrates high diagnostic performance in the diagnosis of active inflammation in pediatric patients with IBD, especially at the per-patient level.

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“…The CE-T1W sequence is important for evaluating active inflammation in CD. 8 , 9 , 10 With the advantage of rapid acquisitions, the 3D-GRE sequence is the SOC technique for CE-T1W MRE. However, this sequence is susceptible to motion artifacts, as obtaining high-resolution CE-T1W MRE within one breath hold could be challenging due to bowel peristalsis, respiration, and limited breath holding.…”

Section: Discussionmentioning

confidence: 99%

“…Contrast-enhanced T1-weighted (CE-T1W) coronal imaging is a key component of MRE for evaluating the extent and severity of bowel inflammation. 8 , 9 , 10 CE-T1WCE-T1W coronal dynamic images are acquired using ultrafast spoiled gradient-echo (GRE) sequences with fat suppression. Currently, three-dimensional (3D) volumetric imaging techniques allow us to obtain near-isotropic dynamic images that provide high-spatial-resolution images with a relatively short total acquisition time.…”

mentioning

confidence: 99%

LAVA HyperSense and deep-learning reconstruction for near-isotropic (3D) enhanced magnetic resonance enterography in patients with Crohn’s disease: utility in noise reduction and image quality improvement

Son¹,

Lee²,

Lee³

et al. 2023

dir

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PURPOSE This study aimed to compare near-isotropic contrast-enhanced T1-weighted (CE-T1W) magnetic resonance enterography (MRE) images reconstructed with vendor-supplied deep-learning reconstruction (DLR) with those reconstructed conventionally in terms of image quality. METHODS A total of 35 patients who underwent MRE for Crohn’s disease between August 2021 and February 2022 were included in this retrospective study. The enteric phase CE-T1W MRE images of each patient were reconstructed with conventional reconstruction and no image filter (original), with conventional reconstruction and image filter (filtered), and with a prototype version of AIR TM Recon DL 3D (DLR), which were then reformatted into the axial plane to generate six image sets per patient. Two radiologists independently assessed the images for overall image quality, contrast, sharpness, presence of motion artifacts, blurring, and synthetic appearance for qualitative analysis, and the signal-to-noise ratio (SNR) was measured for quantitative analysis. RESULTS The mean scores of the DLR image set with respect to overall image quality, contrast, sharpness, motion artifacts, and blurring in the coronal and axial images were significantly superior to those of both the filtered and original images ( P < 0.001). However, the DLR images showed a significantly more synthetic appearance than the other two images ( P < 0.05). There was no statistically significant difference in all scores between the original and filtered images ( P > 0.05). In the quantitative analysis, the SNR was significantly increased in the order of original, filtered, and DLR images ( P < 0.001). CONCLUSION Using DLR for near-isotropic CE-T1W MRE improved the image quality and increased the SNR.

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Contrast-enhanced MR enterography as a stand-alone tool to evaluate Crohn's disease in a paediatric population

Cited by 9 publications

References 28 publications

Impact of gadolinium‐based contrast agent in the assessment of Crohn's disease activity: Is contrast agent injection necessary?

Impact of gadolinium‐based contrast agent in the assessment of Crohn's disease activity: Is contrast agent injection necessary?

Diagnostic Performance of Magnetic Resonance Enterography for Detection of Active Inflammation in Children and Adolescents With Inflammatory Bowel Disease

LAVA HyperSense and deep-learning reconstruction for near-isotropic (3D) enhanced magnetic resonance enterography in patients with Crohn’s disease: utility in noise reduction and image quality improvement

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