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Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

2008; Wiley; Volume: 28; Issue: 5 Linguagem: Inglês

10.1002/jmri.21574

1522-2586

Unni Udayasankar, Diego R. Martín, Thomas C. Lauenstein, Robin E. Rutherford, John R. Galloway, Dana Tudorascu, Shanthi V. Sitaraman,

Diverticular Disease and Complications

Abstract Purpose To retrospectively evaluate the efficacy of spectral presaturation attenuated inversion‐recovery (SPAIR) fat‐suppressed (FS) partial Fourier single shot (SSH) T2‐weighted (T2W) and gadolinium‐enhanced (Gd) FS 3D‐gradient echo (3DGRE) T1‐weighted (T1W) delayed phase MRI to differentiate active bowel inflammation from fibrotic disease in patients with Crohn's disease (CD). Materials and Methods MRI studies of 81 patients (mean age, 43 years; range, 22–77 years; M:F ratio 33:48) had T2W and T1W imaging including SPAIR‐SSH and delayed Gd‐3DGRE. The ability to assess disease activity in bowel segments affected were retrospectively evaluated by a grading scheme based on subjective analysis of signal intensities. These results were compared against the standard clinical parameters of disease activity. Results SPAIR‐SSH images correlated better ( r = 0.74, P < 0.0001) with activity than delayed Gd‐3DGRE ( r = 0.39, P = 0.0003), with a significant difference between the two techniques ( P < 0.0001). SPAIR‐SSH images showed higher specificity in detection of severely active disease in per patient (98%) and segmental (98%) analysis compared to Gd‐3DGRE (57%, 70%). Gd‐3DGRE technique showed significantly higher sensitivity ( P = 0.01) in identifying active disease in per patient (83%) and segmental (85%) analysis compared to SPAIR‐SSH (70%, 64%). Conclusion SPAIR‐SSH detects actively diseased CD bowel segments with a high level of specificity. Noninflammatory bowel fibrosis corresponds to abnormal uptake on delayed phase Gd‐3DGRE images but without associated elevated abnormal signal on SPAIR‐SSH. J. Magn. Reson. Imaging 2008;28:1133–1140. © 2008 Wiley‐Liss, Inc.