ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2021
vol. 86
 
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Gastrointestinal and abdominal radiology
abstract:
Original paper

The value of magnetic resonance enterography in diagnostic difficulties associated with Crohn’s disease

Katarzyna B. Biernacka
1
,
Dobromiła Barańska
1
,
Katarzyna Matera
1
,
Michał Podgórski
1
,
Elżbieta Czkwianianc
2
,
Katarzyna Szabelska-Zakrzewska
2
,
Inga Dziembowska
3
,
Piotr Grzelak
1

1.
Department of Diagnostic Imaging, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
2.
Department of Gastroenterology, Allergology and Paediatrics, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
3.
Department of Pathophysiology, Faculty of Pharmacy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
Pol J Radiol 2021; 86: e143-e150
Online publish date: 2021/03/03
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Introduction
The diagnosis of Crohn’s disease (CD), one of the inflammatory bowel diseases (IBD), along with ulcera­tive colitis (UC), is often challenging due to the limitations of small intestine visualisation. Magnetic resonance enterography (MRE) enables imaging of intraluminal and extraintestinal complications without ionizing radiation. The objective of this study is to select CD-related MRE features and determine the feasibility of this technique to indicate a group of patients that should be subjected to more invasive diagnostic procedures.

Material and methods
A total of 131 patients (mean age 25) underwent MRE, 60 of whom had been previously diagnosed with CD and 17 with UC. Additionally, 26 patients with suspected IBD and 28 with other or unknown patholo­gies were included in the study. Radiological reports of MRE examinations, effectuated using a 1.5-T field strength, were retrospectively analysed regarding radiological features of IBD, such as the following: bowel wall thickening, enhancement, comb sign, stricture, enlarged mesenteric nodes, inflammatory infiltration, and abnormal diffusion restriction in diffusion-weighted imaging. The statistical model was based on machine learning of the Kohonen map, together with univariate and multivariate analysis.

Results
The selected neuron (Neuron 3) incorporated 23 cases of CD, 9 of suspected IBD, 2 patients with UC, and 4 with other pathologies. The statistical analysis identified bowel wall thickening, intestinal stricture, and lymphadenopathy as the 3 MRE findings most associated with Neuron 3 (AUC = 0.919, p = 0.031).

Conclusions
Bowel wall thickening, stricture, and enlarged mesenteric lymph nodes in MRE are independent predictive factors for CD diagnosis; thus, patients presenting these features should undergo further examinations. MRE constitutes a powerful imaging modality in cases of suspected IBD.

keywords:

inflammatory bowel disease, Crohn’s disease, ulcerative colitis, magnetic resonance enterography

 
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