Detection of bowel inflammation with fused DWI/T2 images versus contrast-enhanced images in pediatric MR enterography with histopathologic correlation

Clin Imaging. 2016 Nov-Dec;40(6):1135-1139. doi: 10.1016/j.clinimag.2016.07.006. Epub 2016 Jul 21.

Abstract

Purpose: To evaluate the fused, colorized diffusion weighted imaging (DWI) and anatomic T2 images compared to routine contrast-enhanced T1 images at pediatric magnetic resonance enterography (MRE).

Methods: Fused, colorized DWI/T2 images were created from patients with magnetic resonance enterography (MRE) and colonoscopy/biopsy. Radiologists noted inflammation in five bowel segments (terminal ileum-rectosigmoid colon) on postcontrast images and DWI/T2 images. Test characteristics and agreement were calculated.

Results: For 20 patients, sensitivity/specificity/positive predictive value (PPV)/negative predictive value (NPV) were 0.53/0.90/0.77/0.76 for DWI/T2 and 0.45/0.90/0.72/0.73 for postcontrast images. Intraobserver agreement was ҡ=0.45-0.73. Interobserver agreement was ҡ=0.53 for DWI/T2 and ҡ=0.63 for postcontrast images.

Conclusion: DWI/T2 images are similar in sensitivity/specificity to contrast-enhanced images and with moderate intra/interobserver reliability.

Keywords: Diffusion-weighted imaging; Enterography; MRI; Pediatric.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Child
  • Colitis / diagnosis*
  • Contrast Media
  • Diffusion Magnetic Resonance Imaging / methods
  • Female
  • Humans
  • Ileitis / diagnosis*
  • Image Enhancement
  • Irritable Bowel Syndrome / diagnosis
  • Male
  • Observer Variation
  • Proctocolitis / diagnosis
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Contrast Media