MR Measures of Small Bowel Wall <scp>T2</scp> Are Associated With Increased Permeability

Scott, Robert A.; Williams, Hannah; Hoad, Caroline L.; Alyami, Ali S; Ortori, Catharine A.; Grove, Jane I.; Marciani, Luca; Moran, Gordon W; Spiller, Robin C.; Menys, Alex; Aithal, Guruprasad P.; Gowland, Penny

doi:10.1002/jmri.27463

Cited by 8 publications

(12 citation statements)

References 37 publications

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“…Signed informed consent was obtained from all participants prior to recruitment. A subset of the T2 data has been reported previously [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The dataset was motion-corrected to remove distortions due to respiration and peristalsis [ 19 ] using a non-linear intensity-based motion correction algorithm in Matlab®. The analysis was performed using a semi-automated program which used edge detection and thresholding to isolate the bowel wall [ 19 ]. The wall was then split into multiple ROIs and the signal from each ROI fitted for T2 taking account of the effect of the full bTFE readout [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…MT reflects the exchange of magnetisation between protons in free water and protons bound to semisolid macromolecules and other moieties, and hence is a potential non-invasive measure of collagen deposition and intestinal fibrosis [8,[11][12][13]. Quantitative relaxometry T1 and T2 measures have shown potential as markers of fibrosis and inflammation in the liver [14,15], pancreas [16,17] and kidneys [18] and T2 of the small bowel wall has been shown to be related to intestinal permeability [19]. However, T1 and T2 measures have not been widely investigated in intestinal wall imaging.…”

Section: Introductionmentioning

confidence: 99%

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Test–retest assessment of non-contrast MRI sequences to characterise and quantify the small bowel wall in healthy participants

Alyami

Williams

Argyriou

et al. 2021

Magn Reson Mater Phy

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Objective Quantitative Magnetic Resonance Imaging sequences have been investigated as objective imaging biomarkers of fibrosis and inflammation in Crohn’s disease. Aim To determine the repeatability and inter- and intra-observer agreement of these measures in the prepared small bowel wall. Methods Ten healthy participants were scanned at 3 T on 2 separate occasions using T1 and T2 relaxometry, IVIM-DWI and MT sequences. Test–retest repeatability was assessed using the coefficient of variation (CoV) and intra-class correlation coefficients (ICCs) were used to evaluate the intra- and inter-observer agreement Results Test–retest repeatability in the bowel wall was excellent for apparent diffusion coefficient (ADC), magnetisation transfer ratio (MTR), T1, and diffusion coefficient D (CoV 5%, 7%, 8%, and 10%, respectively), good for perfusion fraction (PF) (CoV 20%) and acceptable for T2 (CoV 21%). Inter-observer agreement was good for the T2, D and ADC (ICC = 0.89, 0.86, 0.76, respectively) and moderate for T1 (ICC = 0.55). Intra-observer agreement was similar to inter-observer agreement. Discussion This study showed variable results between the different parameters measured. Test–retest repeatability was at least acceptable for all parameters except pseudo-diffusion coefficient D*. Good inter- and intra-observer agreement was obtained for T2, ADC and D, with these parameters performing best in this technical validation study.

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“…Signed informed consent was obtained from all participants prior to recruitment. A subset of the T2 data has been reported previously [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Test–retest assessment of non-contrast MRI sequences to characterise and quantify the small bowel wall in healthy participants

Alyami

Williams

Argyriou

et al. 2021

Magn Reson Mater Phy

View full text Add to dashboard Cite

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“…Moreover, T2W images to date have all been mainly 2D and qualitatively assessed. Quantitative T2W image is a step-change that now allows more objective and reproducible disease assessments that should enhance the performance of MRI in the non-invasive measurement of colonic inflammation [48,49].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

et al. 2021

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Endoscopy is the gold standard for objective assessment of colonic disease activity in inflammatory bowel disease (IBD). Non-invasive colonic imaging using bowel ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) may have a role in quantifying colonic disease activity. We reviewed the diagnostic accuracy of these modalities for assessment of endoscopically or histopathologically defined colonic disease activity in IBD. We searched Embase, MEDLINE, and the Web of Science from inception to 20 September 2021. QUADAS-2 was used to evaluate the studies’ quality. A meta-analysis was performed using a bivariate model approach separately for MRI and US studies only, and summary receiver operating characteristic (ROC) curves were obtained. CT studies were excluded due to the absence of diagnostic test data. Thirty-seven studies were included. The mean sensitivity and specificity for MRI studies was 0.75 and 0.91, respectively, while for US studies it was 0.82 and 0.90, respectively. The area under the ROC curves (AUC) was 0.88 (95% CI, 0.82 to 0.93) for MRI, and 0.90 (95% CI, 0.75 to 1.00) for US. Both MRI and US show high diagnostic accuracy in the assessment of colonic disease activity in IBD patients.

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Feasibility of IntestinalMRElastography in Inflammatory Bowel Disease

Reiter

Loch

Kamphues

et al. 2021

Magnetic Resonance Imaging

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Background While MR enterography allows detection of inflammatory bowel disease (IBD), the findings continue to be of limited use in guiding treatment—medication vs. surgery. Purpose To test the feasibility of MR elastography of the gut in healthy volunteers and IBD patients. Study Type Prospective pilot. Population Forty subjects (healthy volunteers: n = 20, 37 ± 14 years, 10 women; IBD patients: n = 20 (ulcerative colitis n = 9, Crohn's disease n = 11), 41 ± 15 years, 11 women). Field Strength/Sequence Multifrequency MR elastography using a single‐shot spin‐echo echo planar imaging sequence at 1.5 T with drive frequencies of 40, 50, 60, and 70 Hz. Assessment Maps of shear‐wave speed (SWS, in m/s) and loss angle (φ, in rad), representing stiffness and solid–fluid behavior, respectively, were generated using tomoelastography data processing. Histopathological analysis of surgical specimens was used as reference standard in patients. Statistical Tests Unpaired t‐test, one‐way analysis of variance followed by Tukey post hoc analysis, Pearson's correlation coefficient and area under the receiver operating characteristic curve (AUC) with 95%‐confidence interval (CI). Significance level of 5%. Results MR elastography was feasible in all 40 subjects (100% technical success rate). SWS and φ were significantly increased in IBD by 21% and 20% (IBD: 1.45 ± 0.14 m/s and 0.78 ± 0.12 rad; healthy volunteers: 1.20 ± 0.14 m/s and 0.65 ± 0.06 rad), whereas no significant differences were found between ulcerative colitis and Crohn's disease (P = 0.74 and 0.90, respectively). In a preliminary assessment, a high diagnostic accuracy in detecting IBD was suggested by an AUC of 0.90 (CI: 0.81–0.96) for SWS and 0.84 (CI: 0.71–0.95) for φ. Data Conclusion In this pilot study, our results demonstrated the feasibility of MR elastography of the gut and showed an excellent diagnostic performance in predicting IBD. Evidence Level 1 Technical Efficacy Stage 1

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MR Measures of Small Bowel Wall T2 Are Associated With Increased Permeability

Cited by 8 publications

References 37 publications

Test–retest assessment of non-contrast MRI sequences to characterise and quantify the small bowel wall in healthy participants

Test–retest assessment of non-contrast MRI sequences to characterise and quantify the small bowel wall in healthy participants

Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Feasibility of IntestinalMRElastography in Inflammatory Bowel Disease

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