Hydro-MRI in Crohn’s Disease

Schunk, K.; Kern, A; Oberholzer, K; Kalden, P.; Mayer, Ine; Orth, Thomas; Wanitschke, R.

doi:10.1097/00004424-200007000-00006

Cited by 116 publications

(14 citation statements)

References 22 publications

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“…It seems logical that a partly subjective index does not necessarily correlate with anatomy-based grading of disease activity. Our hypothesis is supported by earlier studies (2,38) that showed low correlation coefficients between CDEIS and CDAI, and between individual MR parameters and CDAI (28). To our knowledge, seven prospective studies have examined the accuracy of MRI for assessing CD in an adult population using endoscopy as the gold standard (27)(28)(29)(30)(31)(32)(33).…”

Section: Discussionsupporting

confidence: 85%

“…However, before MRI can be considered an alternative for endoscopy in CD, it should be firmly established that in addition to detecting disease activity, MRI is capable of revealing both the severity and the exact location of disease. A few prospective studies have compared MRI with endoscopy regarding the severity of disease, but only the five most recent of these studies also analyzed the accuracy of MRI for localizing disease (27)(28)(29)(30)(31)(32)(33). The results of these studies were conflicting, and the reported sensitivities and specificities varied widely from approaching endoscopic accuracy to considerable over-or underestimation of disease.…”

mentioning

confidence: 99%

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Feasibility of evaluating Crohn's disease activity at 3.0 Tesla

Gemert-Horsthuis

Florie

Hommes

et al. 2006

Magnetic Resonance Imaging

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Purpose: To determine whether abdominal 3.0T MRI can be used for evaluation of Crohn's disease (CD) compared with ileocolonoscopy (CS), and to determine patient preference for MRI as opposed to CS. Materials and Methods:Twenty patients scheduled for CS underwent MRI. At CS, disease severity was graded and the Crohn's Disease Endoscopic Index of Severity (CDEIS) was determined. Radiological grading (by two observers) was compared with endoscopic grading and CDEIS. Patient experience and preference were determined. Results:In respectively 10 (observer 1) and 13 patients (observer 2) exact agreement between radiological and endoscopic grading was found. In respectively 10 and 7 patients radiological and endoscopic grading differed one level. No statistically significant correlation was found between radiological grading and CDEIS. Between bowel wall thickness and CDEIS weak to moderate correlations were found, and between bowel wall enhancement and CDEIS weak correlations were found. All patients preferred MRI over CS. Conclusion:It is feasible to perform abdominal 3.0T MRI using orally administered contrast medium for evaluation of CD, and this method can be considered a patient-friendly alternative to CS.

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Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 99%

Feasibility of evaluating Crohn's disease activity at 3.0 Tesla

Gemert-Horsthuis

Florie

Hommes

et al. 2006

Magnetic Resonance Imaging

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“…Complications such as fistulae, phlegmons or abscesses may be more accurately diagnosed on T1-weighted FLASH images with fat saturation by the characteristic pattern of enhancement after gadolinium administration [6]. The latter sequence is additionally useful in active disease because of the marked contrast uptake in the thickened SB wall [11,12] and mesenteric lymph node enhancement [13]. As suggested by the current study and others, disease activity can be appreciated on MRE [11][12][13][14][15], and this may Intramural fat can be accurately identified when combining features from true FISP and gadoliniumenhanced 3D FLASH images with fat saturation.…”

Section: Discussionmentioning

confidence: 99%

Imaging of small intestinal Crohn’s disease: comparison between MR enteroclysis and conventional enteroclysis

et al. 2006

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The purpose of this study was to compare MR enteroclysis (MRE) with conventional enteroclysis (CE) in patients with small intestinal Crohn's disease. Fifty-two consecutive patients with known or suspected Crohn's disease underwent MR and conventional enteroclysis, which was considered the gold standard. Eleven imaging features, classified in three groups, mucosal, transmural and extraintestinal, were subjectively evaluated by two experienced radiologists. MRE and CE were in full agreement in revealing, localizing and estimating the length of all involved segments of the small bowel. The sensitivity of MRE for the detection of superficial ulcers, fold distortion and fold thickening was 40, 30 and 62.5%, respectively. The sensitivity of MRE for the detection of deep ulcers, cobble-stoning pattern, stenosis and prestenostic dilatation was 89.5, 92.3, 100 and 100%, respectively. Additional findings demonstrated on MRE images included fibrofatty proliferation in 15 cases and mesenteric lymphadenopathy in 19 cases. MRE strongly correlates with CE in the detection of individual lesions expressing small intestinal Crohn's disease. It provides additional information from the mesenteries; however, its capability to detect subtle lesions is still inferior to conventional enteroclysis.

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“…Magnetic resonance imaging (MRI) of the small bowel is a cross sectional imaging technique which provides an accurate and reproducible diagnostic evaluation. Although IBDs early changes of mucosa can be difficult to assess with MRI, the mural changes and the extra intestinal findings are evaluated with a high diagnostic accuracy [1,2].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of MRI in Experimentally Induced Inflammatory Small Bowel Disease: A Pilot Study in a Porcine Model

et al. 2009

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The purpose of this study was to compare the macroscopic and microscopic findings of experimentally induced inflammatory lesions in jejunum and ileum with magnetic resonance imaging (MRI) findings. Inflammatory small bowel lesions were experimentally induced in six pigs. Bowel segments in jejunum and ileum were isolated, and a solution with trinitrobenzenesulfonic acid and ethanol (TNBS-EtOH) was installed. MRI of the small bowel was performed 7 days after surgery. Before the MRI examination, a 6% mannitol solution was installed through a nasogastric tube. The MRI protocol consisted of single-shot turbo spin echo T2 sequences, steady state free precession (BFFE) sequences, and a 3D T1 gradient echo sequence with fat saturation and intravenous contrast. The following image findings were evaluated: increased bowel wall thickness (BWT), increased bowel wall enhancement (BWE), and bowel stenosis. After the MRI examination, the animals were sacrificed. The small bowel was removed and examined macroscopically and microscopically. Inflammatory lesions developed in jejunum and ileum in all animals. The lesions were visible macroscopically and microscopically. The microscopic findings consisted of variable degrees of inflammation, ulcer formation, and fibrosis. In jejunum the inflammatory lesions were not diagnosed with MRI, except in one pig with a bowel necrosis probably caused by an intramural injection or leakage of the TNBS-EtOH solution. In ileum the bowel wall thickness was increased and the inflammatory lesions were diagnosed with MRI. In conclusion, the inflammatory lesions were visible macroscopically and microscopically. Lesions in ileum had increased BWT and were possible to image with MRI. Lesions in jejunum had normal BWT and were not diagnosed with MRI, except in one pig with increased BWT probably caused by complications to the installation of TNBS-EtOH.

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Hydro-MRI in Crohn’s Disease

Cited by 116 publications

References 22 publications

Feasibility of evaluating Crohn's disease activity at 3.0 Tesla

Feasibility of evaluating Crohn's disease activity at 3.0 Tesla

Imaging of small intestinal Crohn’s disease: comparison between MR enteroclysis and conventional enteroclysis

Feasibility of MRI in Experimentally Induced Inflammatory Small Bowel Disease: A Pilot Study in a Porcine Model

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