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Diffusion-weighted magnetic resonance without bowel preparation for detecting colonic inflammation in inflammatory bowel disease
Abstract
Objective: Magnetic resonance imaging (MRI) enables accurate assessment of inflammatory bowel diseases (IBD), but its main limitation is the need for bowel preparation. Diffusion-weighted imaging is feasible in Crohn's disease. We evaluated the accuracy of MRI in combination with diffusion-weighted imaging (DWI-MRI) without oral or rectal preparation in assessing colonic inflammation in both ulcerative colitis and Crohn's disease. Design: This was an observational study of a single-centre cohort. Patients: All patients who underwent DWI-MRI-colonography without bowel preparation between January 2008 and February 2010 in our centre were analysed. Results: Among the 96 patients (ulcerative colitis=35; Crohn's disease=61) who had DWI-MRI-colonography, 68 had concomitant endoscopy. In ulcerative colitis a segmental magnetic resonance score (MR-score-S) >1 detected endoscopic inflammation with a sensitivity and specificity of 89.47% and 86.67%, respectively (AUROC=0.920, p=0.0001). In the Crohn's disease group, a MR-score-S >2 detected endoscopic inflammation in the colon with a sensitivity and specificity of 58.33% and 84.48%, respectively (AUROC=0.779, p=0.0001). The MR-score-S demonstrated better accuracy for the detection of endoscopic inflammation in the ulcerative colitis group than in the Crohn's disease group (p=0.003). In ulcerative colitis, the proposed total magnetic resonance score (MR-score-T) correlated with the total modified Baron score (r=0.813, p=0.0001) and the Walmsley index (r=0.678, p<0.0001). In Crohn's disease, the MR-score-T correlated with the simplified endoscopic activity score for Crohn's disease (r=0.539, p=0.001) and the Crohn's disease activity index (r=0.367, p=0.004). The DWI hyperintensity was a predictor of colonic endoscopic inflammation in ulcerative colitis (OR=13.26, 95% CI 3.6 to 48.93; AUROC=0.854, p=0.0001) and Crohn's disease (OR=2.67, 95% CI 1.25 to 5.72; AUROC=0.702, p=0.0001). The accuracy of the DWI hyperintensity for detecting colonic inflammation was greater in ulcerative colitis than in Crohn's disease (p=0.004). Conclusions: DWI-MRI-colonography without bowel preparation is a reliable tool for detecting colonic inflammation in ulcerative colitis.
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DeLong, E. R., DeLong, D. M., & Clarke-Pearson, D. L. (1988) · Biometrics · doi:10.2307/2531595 · Cited by 22,649
Cited by
Panes, J., Bouhnik, Y., Reinisch, W., Stoker, J., Taylor, S. A., Baumgart, D. C., Danese, S., Halligan, S., Marincek, B., Matos, C., et al. (2013) · Journal of Crohn's and Colitis · doi:10.1016/j.crohns.2013.02.020 · Cited by 668
Self-citationArasaradnam, R. P., Brown, S., Forbes, A., Fox, M. R., Hungin, P., Kelman, L., Major, G., O’Connor, M., Sanders, D. S., Sinha, R., et al. (2018) · Gut · doi:10.1136/gutjnl-2017-315909 · Cited by 332
Rimola, J., Planell, N., Rodríguez, S., Delgado, S., Ordás, I., Ramírez-Morros, A., Ayuso, C., Aceituno, M., Ricart, E., Jauregui-Amezaga, A., et al. (2015) · American Journal of Gastroenterology · doi:10.1038/ajg.2014.424 · Cited by 270
Current best practice for disease activity assessment in IBD
Walsh, A. J., Bryant, R. V., & Travis, S. P. L. (2016) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2016.128 · Cited by 223
Kucharzik, T., Tielbeek, J., Carter, D., Taylor, S. A., Tolan, D., Wilkens, R., Bryant, R. V., Hoeffel, C., De Kock, I., Maaser, C., et al. (2022) · Journal of Crohn's and Colitis · doi:10.1093/ecco-jcc/jjab180 · Cited by 149
Metadata
- Authors
- Oussalah, A., Laurent, V., Bruot, O., Bressenot, A., Bigard, M.-A., Régent, D., & Peyrin-Biroulet, L.
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2010-06-04
- Volume
- 59
- Issue
- 8
- Pages
- 1056-1065
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W2145026064
- Cited by
- 263
- References
- 1
- FWCI
- 9.22
- Type
- journal article
- Language
- en
- Open access
- closed
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- Oussalah, A., Laurent, V., Bruot, O., Bressenot, A., Bigard, M.-A., Régent, D., & Peyrin-Biroulet, L. (2010). Diffusion-weighted magnetic resonance without bowel preparation for detecting colonic inflammation in inflammatory bowel disease. Gut. https://doi.org/10.1136/gut.2009.197665
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