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Clinical Article
The clinical application value of DWI in quantitative evaluation of Crohn′s disease lesions
CHENG Jingyun  ZHA Yunfei  LIU Changsheng  LI Yushuang  YANG Renjie 

Cite this article as: Cheng JY, Zha YF, Liu CS, et al. The clinical application value of DWI in quantitative evaluation of Crohn′s disease lesions[J]. Chin J Magn Reson Imaging, 2022, 13(1): 48-53. DOI:10.12015/issn.1674-8034.2022.01.010.


[Abstract] Objective To explore the value of magnetic resonance diffusion weighted imaging (DWI) to quantitatively assess the activity of intestinal Crohn's disease (CD) lesions.Materials and Methods: A total of 51 patients diagnosed with CD were retrospectively analyzed, all of those were underwent magnetic resonance enterography (MRE), DWI and enteroscopy within 2 weeks. The lesions of bowel segments were graded as inactive (0-2), mild (3-6), and moderate-severe group (>6) based on simplified endoscopic activity score for Crohn′s disease (SES-CD).To observe the performance of MRE and DWI, and calculate the magnetic resonance index of activity (MaRIA) and the apparent diffusion coefficient (ADC) value of the lesions. The Kruskal-Wallis rank sum test was applied to compare the differences in MaRIA and ADC values among different activity groups, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of MaRIA and ADC values to distinguish different active lesions. Spearman analysis was used to evaluate the correlation between SES-CD and MaRIA, ADC values.Results A total of 127 intestinal segments were included in the study. There were 15 inactive, 45 mild, and 67 moderate-severe. The SES-CD score ranged from 1.0 to 11.0. There were significant differences in MaRIA and ADC values among different groups (P<0.01). The correlations between SES-CD and MaRIA, ADC values were 0.793 (P<0.01) and -0.742 (P<0.01), respectively. ROC curve analysis found that when the MaRIA was the threshold at 9.1 and the ADC value was the threshold at -1.585×10-3 mm2/s, the maximum of area under the curves (AUCs) to distinguish the inactive from the active were 0.962 (P<0.01) and 0.957 (P<0.01), respectively. When the MaRIA was the threshold at 11.1 and the ADC value was the threshold at -1.345×10-3 mm2/s, the maximum of AUCs to distinguish the inactive-mild from the moderate-severe were 0.942 (P<0.01) and 0.920 (P<0.01), respectively.Conclusions DWI can quantitatively and accurately distinguish the lesions in different active stages of CD.
[Keywords] Crohn's disease;magnetic resonance imaging;diffusion weighted imaging;activity score

CHENG Jingyun   ZHA Yunfei*   LIU Changsheng   LI Yushuang   YANG Renjie  

Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China

Zha YF, E-mail: zhayunfei999@126.com

Conflicts of interest   None.

Received  2021-07-16
Accepted  2021-11-26
DOI: 10.12015/issn.1674-8034.2022.01.010
Cite this article as: Cheng JY, Zha YF, Liu CS, et al. The clinical application value of DWI in quantitative evaluation of Crohn′s disease lesions[J]. Chin J Magn Reson Imaging, 2022, 13(1): 48-53.DOI:10.12015/issn.1674-8034.2022.01.010

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