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Pediatric Radiology
Published in: Pediatric Radiology 1/2013

01-01-2013 | Original Article

Small-bowel MRI in children and young adults with Crohn disease: retrospective head-to-head comparison of contrast-enhanced and diffusion-weighted MRI

Authors: Henning Neubauer, Thomas Pabst, Anke Dick, Wolfram Machann, Laura Evangelista, Clemens Wirth, Herbert Köstler, Dietbert Hahn, Meinrad Beer

Published in: Pediatric Radiology | Issue 1/2013

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Abstract

Background

Small-bowel MRI based on contrast-enhanced T1-weighted sequences has been challenged by diffusion-weighted imaging (DWI) for detection of inflammatory bowel lesions and complications in patients with Crohn disease.

Objective

To evaluate free-breathing DWI, as compared to contrast-enhanced MRI, in children, adolescents and young adults with Crohn disease.

Materials and methods

This retrospective study included 33 children and young adults with Crohn disease ages 17 ± 3 years (mean ± standard deviation) and 27 matched controls who underwent small-bowel MRI with contrast-enhanced T1-weighted sequences and DWI at 1.5 T. The detectability of Crohn manifestations was determined. Concurrent colonoscopy as reference was available in two-thirds of the children with Crohn disease.

Results

DWI and contrast-enhanced MRI correctly identified 32 and 31 patients, respectively. All 22 small-bowel lesions and all Crohn complications were detected. False-positive findings (two on DWI, one on contrast-enhanced MRI), compared to colonoscopy, were a result of large-bowel lumen collapse. Inflammatory wall thickening was comparable on DWI and contrast-enhanced MRI. DWI was superior to contrast-enhanced MRI for detection of lesions in 27% of the assessed bowel segments and equal to contrast-enhanced MRI in 71% of segments.

Conclusion

DWI facilitates fast, accurate and comprehensive workup in Crohn disease without the need for intravenous administration of contrast medium. Contrast-enhanced MRI is superior in terms of spatial resolution and multiplanar acquisition.
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Metadata
Title
Small-bowel MRI in children and young adults with Crohn disease: retrospective head-to-head comparison of contrast-enhanced and diffusion-weighted MRI
Authors
Henning Neubauer
Thomas Pabst
Anke Dick
Wolfram Machann
Laura Evangelista
Clemens Wirth
Herbert Köstler
Dietbert Hahn
Meinrad Beer
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 1/2013
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-012-2492-1

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