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Can diffusion weighting replace gadolinium enhancement in magnetic resonance enterography for inflammatory bowel disease in children?

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Abstract

Background

Contrast-enhanced MRI is often used for diagnosis and follow-up of children with inflammatory bowel disease.

Objective

To compare the accuracy of diffusion-weighted MRI (DWI) to contrast-enhanced MRI in children with known or suspected inflammatory bowel disease.

Materials and methods

This retrospective, consecutive study included 55 children. We used ileo-colonoscopy and histology as the reference standard from the terminal ileum to the rectum, and contrast-enhanced MRI as the reference standard proximal to the terminal ileum. DWI and contrast-enhanced MRI sequences were independently reviewed and compared per patient and per segment to these reference standards and to the follow-up for each child.

Results

We obtained endoscopic data for 340/385 colonic and ileal segments (88%). The rate of agreement per segment between DWI and endoscopy was 64%, and the rate of agreement between contrast-enhanced MRI and endoscopy was 59%. Per patient, sensitivity and specificity of bowel wall abnormalities as compared to the endoscopy were 87% and 100% for DWI, and 70% and 100% for contrast-enhanced MRI, respectively. Positive and negative predictive values were, respectively, 100% and 57% for DWI, and 96% and 41% for contrast-enhanced MRI. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of DWI compare to contrast-enhanced MRI in the segments proximal to the terminal ileum were 90%, 98%, 90%, 98% and 96%, respectively.

Conclusion

The diagnostic performance of DWI is competitive to that of contrast-enhanced MRI in children with known or suspected inflammatory bowel disease.

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Authors and Affiliations

  1. Pediatric Radiology Department, Hopital de la Timone, Assistance Publique des Hopitaux de Marseille, 264 Rue Saint-Pierre, 13385, Marseille Cedex 5, Marseille, France

    Farah Khachab, Nathalie Colavolpe, Audrey Aschero, Brigitte Bourlière-Najean, Nassima Daidj, Catherine Desvignes, Harmony Pico, Guillaume Gorincour & Philippe Petit

  2. Public Health Department, Hopital de la Timone, Assistance Publique des Hopitaux de Marseille, Marseille, France

    Anderson Loundou & Pascal Auquier

  3. Pediatric Gastroenterology Department, Hopital de la Timone, Assistance Publique des Hopitaux de Marseille, Marseille, France

    Céline Roman

Authors
  1. Farah Khachab
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  2. Anderson Loundou
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  3. Céline Roman
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  4. Nathalie Colavolpe
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  12. Philippe Petit
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Correspondence to Philippe Petit.

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Khachab, F., Loundou, A., Roman, C. et al. Can diffusion weighting replace gadolinium enhancement in magnetic resonance enterography for inflammatory bowel disease in children?. Pediatr Radiol 48, 1432–1440 (2018). https://doi.org/10.1007/s00247-018-4169-x

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  • DOI: https://doi.org/10.1007/s00247-018-4169-x

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