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Intestinal lesions in pediatric Crohn disease: comparative detectability among pulse sequences at MR enterography

 Beomseok Sohn  ;  Myung-Joon Kim  ;  Hong Koh  ;  Kyung Hwa Han  ;  Mi-Jung Lee 
 PEDIATRIC RADIOLOGY, Vol.44(7) : 821-830, 2014 
Journal Title
Issue Date
Adolescent ; Contrast Media ; Crohn Disease/pathology* ; Female ; Humans ; Image Enhancement ; Intestines/pathology ; Magnetic Resonance Imaging/methods* ; Male ; Meglumine ; Organometallic Compounds ; Retrospective Studies
Crohn disease ; Inflammatory bowel disease ; Magnetic resonance imaging ; Child ; Small intestine ; Magnetic resonance enterography
BACKGROUND: Variable sequences can be used in MR enterography, and no consensus exists for the best protocol in children with Crohn disease. OBJECTIVE: To compare the lesion detectability of various MR enterography sequences and to correlate the findings of these sequences with the Pediatric Crohn's Disease Activity Index (PCDAI) in children with Crohn disease. MATERIALS AND METHODS: Children with clinically or pathologically confirmed Crohn disease underwent MR enterography, including a single-shot fast spin-echo (SSFSE) sequence, motility imaging (coronal 2-D balanced fast field echo), diffusion-weighted imaging (DWI), and dynamic contrast enhancement imaging (including arterial, portal and delayed phases). The lesion detectability of each sequence was graded 0-2 for each involved bowel segment. The lesion detectability and PCDAI result on different sequences were compared using the weighted least squares method and Student's t-test, respectively. RESULTS: Fifteen children (11 boys, 4 girls, mean age 13.7 ± 1.4 years) with a total of 41 lesions were included in this study. All lesions detected in more than two sequences were visible on the single-shot fast spin-echo (SSFSE) sequence. The relative lesion detection rate was 78.1% on motility imaging, 90.2% on DWI, and 92.7% on arterial, 95.1% on portal and 95.1% on delayed phase imaging. Compared to the SSFSE sequence, motility imaging (P < 0.001) and DWI (P = 0.039) demonstrated lower detectability. The mean PCDAI result in the detected lesions was statistically higher only on dynamic enhancement imaging (P < 0.001). CONCLUSION: All MR enterography sequences were found to have relatively high lesion detectability in children with Crohn disease, while motility imaging showed the lowest lesion detectability. Lesions detected on dynamic enhancement imaging showed a higher PCDAI result, which suggests that this sequence is specific for active inflammation.
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1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Kim, Myung Joon(김명준) ORCID logo https://orcid.org/0000-0002-4608-0275
Sohn, Beomseok(손범석) ORCID logo https://orcid.org/0000-0002-6765-8056
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Han, Kyung Hwa(한경화)
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