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Pediatric Radiology
Published in: Pediatric Radiology 7/2014

01-07-2014 | Original Article

Intestinal lesions in pediatric Crohn disease: comparative detectability among pulse sequences at MR enterography

Authors: Beomseok Sohn, Myung-Joon Kim, Hong Koh, Kyung Hwa Han, Mi-Jung Lee

Published in: Pediatric Radiology | Issue 7/2014

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Abstract

Background

Variable sequences can be used in MR enterography, and no consensus exists for the best protocol in children with Crohn disease.

Objective

To compare the lesion detectability of various MR enterography sequences and to correlate the findings of these sequences with the Pediatric Crohn’s Disease Activity Index (PCDAI) in children with Crohn disease.

Materials and methods

Children with clinically or pathologically confirmed Crohn disease underwent MR enterography, including a single-shot fast spin-echo (SSFSE) sequence, motility imaging (coronal 2-D balanced fast field echo), diffusion-weighted imaging (DWI), and dynamic contrast enhancement imaging (including arterial, portal and delayed phases). The lesion detectability of each sequence was graded 0–2 for each involved bowel segment. The lesion detectability and PCDAI result on different sequences were compared using the weighted least squares method and Student’s t-test, respectively.

Results

Fifteen children (11 boys, 4 girls, mean age 13.7 ± 1.4 years) with a total of 41 lesions were included in this study. All lesions detected in more than two sequences were visible on the single-shot fast spin-echo (SSFSE) sequence. The relative lesion detection rate was 78.1% on motility imaging, 90.2% on DWI, and 92.7% on arterial, 95.1% on portal and 95.1% on delayed phase imaging. Compared to the SSFSE sequence, motility imaging (P < 0.001) and DWI (P = 0.039) demonstrated lower detectability. The mean PCDAI result in the detected lesions was statistically higher only on dynamic enhancement imaging (P < 0.001).

Conclusion

All MR enterography sequences were found to have relatively high lesion detectability in children with Crohn disease, while motility imaging showed the lowest lesion detectability. Lesions detected on dynamic enhancement imaging showed a higher PCDAI result, which suggests that this sequence is specific for active inflammation.
Appendix
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Metadata
Title
Intestinal lesions in pediatric Crohn disease: comparative detectability among pulse sequences at MR enterography
Authors
Beomseok Sohn
Myung-Joon Kim
Hong Koh
Kyung Hwa Han
Mi-Jung Lee
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 7/2014
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-014-2902-7

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