Crohn's disease (CD) is a chronic idiopathic inflammatory condition potentially affecting any portion of the alimentary tract. It is characterized by a relapsing-remitting clinical behavior and typically the inflammation along the intestine is segmental and transmural. A key issue in the management of patients with CD concerns how best to assess the disease's extent and inflammatory activity. Magnetic resonance enterography (MRE) is the first-line imaging modality for assessing pediatric patients with CD. Besides the advantages of avoiding any ionizing radiation and obtaining a better soft tissue contrast resolution than with computed tomography, MRE has the ability to investigate disease activity, differentiating between active inflammation and fibrosis, with important implications for disease management [1-6]. Diffusion-weighted imaging (DWI) has been studied in conjunction with MRE with a view to improving the accuracy of disease activity assessments. The DWI technique uses the diffusion of water molecules in biological tissue to create images that reflect changes in water motility caused by interactions with cell membranes, macromolecules, and tissue alterations. In addition to provide images, DWI intrinsically provides quantitative parameters through the apparent diffusion coefficient (ADC) values, helping to quantify the restriction of the water molecules' diffusion [7, 8] (Fig. 1). While numerous published studies have demonstrated the association between active bowel inflammation in CD and restricted mural diffusion on DWI in adult patients [9-13], literature in pediatric patients is limited [14-17]. Aims of the study were to compare DWI findings with morphological MRE sequences in cohorts of pediatric patients with CD, and to quantify the mean ADC for inflamed intestinal segments and areas of inactive disease.

MR enterography in pediatric Crohn's disease: Analyzing the apparent diffusion coefficient to assess active bowel wall inflammation

POMERRI, FABIO
2017

Abstract

Crohn's disease (CD) is a chronic idiopathic inflammatory condition potentially affecting any portion of the alimentary tract. It is characterized by a relapsing-remitting clinical behavior and typically the inflammation along the intestine is segmental and transmural. A key issue in the management of patients with CD concerns how best to assess the disease's extent and inflammatory activity. Magnetic resonance enterography (MRE) is the first-line imaging modality for assessing pediatric patients with CD. Besides the advantages of avoiding any ionizing radiation and obtaining a better soft tissue contrast resolution than with computed tomography, MRE has the ability to investigate disease activity, differentiating between active inflammation and fibrosis, with important implications for disease management [1-6]. Diffusion-weighted imaging (DWI) has been studied in conjunction with MRE with a view to improving the accuracy of disease activity assessments. The DWI technique uses the diffusion of water molecules in biological tissue to create images that reflect changes in water motility caused by interactions with cell membranes, macromolecules, and tissue alterations. In addition to provide images, DWI intrinsically provides quantitative parameters through the apparent diffusion coefficient (ADC) values, helping to quantify the restriction of the water molecules' diffusion [7, 8] (Fig. 1). While numerous published studies have demonstrated the association between active bowel inflammation in CD and restricted mural diffusion on DWI in adult patients [9-13], literature in pediatric patients is limited [14-17]. Aims of the study were to compare DWI findings with morphological MRE sequences in cohorts of pediatric patients with CD, and to quantify the mean ADC for inflamed intestinal segments and areas of inactive disease.
2017
Electronic Presentation Online System EPOS
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/3240731
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