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Original article

Significance of diffusion weighted imaging (DWI) as an improving factor in contrast enhanced magnetic resonance imaging (MRI) enterography in evaluation of patients with Crohn’s disease

Authors
  • Bilal Imširović orcid logo (General Hospital “Prim. dr. Abdulah Nakaš”, Sarajevo, Department of Radiology, Bosnia and Herzegovina)
  • Enver Zerem (University Clinical Centre Tuzla, Tuzla, Department of Gastroenterology, Bosnia and Herzegovina)
  • Alma Efendić (Cantonal Hospital Zenica, Zenica, Department of Radiology, Bosnia and Herzegovina)
  • Alma Mekić Abazović (Cantonal Hospital Zenica, Zenica, Department of Oncology, Bosnia and Herzegovina)
  • Omar Zerem (School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina)
  • Muhamed Djedović (Clinical Centre, University of Sarajevo, Sarajevo, Department of Surgery, Bosnia and Herzegovina)

Abstract

Aim: To determine capabilities and potential of contrast enhanced magnetic resonance imaging (MRI) enterography in order to establish the diagnosis and to evaluate severity and activity of intestinal inflammation.

Methods: Fifty-five patients with suspicion for presence of Crohn's disease were evaluated. All patients underwent contrast enhanced MRI enterography and diffusion weighted imaging (DWI), and subsequently endoscopic examination or surgical treatment. Four parameters were analysed: thickening of the bowel wall, and presence of abscess, fistula and lymphadenopathy.

Results: Comparing results of DWI and contrast enhanced MRI enterography a significant difference between results given through diffusion and histopathological test was found, e.g. a significant difference between results obtained through diffusion and MRI enterography was found. MRI enterography sensitiveness for bowel wall thickening was 97.7% and specificity 70%, whilst DWI sensitivity for bowel wall thickening was 84% and specificity 100%. The diagnostics of abscess and fistula showed no significant difference between DWI and MRI, while in lymphadenopathy significant difference between contrast enhanced MRI enterography and DWI was found.

Conclusion: Contrast enhanced MRI enterography in combination with DWI allows for excellent evaluation of disease activity, but also problems or complications following it. The examination can be repeated, controlled, and it can contribute to monitoring of patients with this disease.

Keywords: magnetic resonance imaging, diffusion, inflammatory bowel disease

How to Cite:

Imširović, B., Zerem, E., Efendić, A., Mekić Abazović, A., Zerem, O. & Djedović, M., (2018) “Significance of diffusion weighted imaging (DWI) as an improving factor in contrast enhanced magnetic resonance imaging (MRI) enterography in evaluation of patients with Crohn’s disease”, Medicinski glasnik 15(2), 145-151. doi: https://doi.org/10.17392/945-18

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Published on
2018-01-25

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CC-BY-NC-ND 4.0