The Role of Dynamic Contrast Enhanced Magnetic Resonance Enterography in Evaluation of Crohn's Disease Activity

Amaç: Dinamik kontrastlı sekansların konvansiyonel manyetik rezonans enterografiye eklenmesinin Crohn hastalığı (CH) aktivitesinin tespitine katkısını değerlendirmek amaçlanmıştır. Gereç ve Yöntem: Crohn hastalığı tanılı ve Crohn hastalığı şüphesi bulunan 28 hastaya yapılmış olan manyetik rezonans enterografi (MRE) incelemeleri ve hasta dosyaları retrospektif olarak değerlendirilmiştir. Kolonoskopileri ve patolojik tanıları mevcut olan hastalardan aktif CH olarak değerlendirilen 17 hasta çalışmaya dahil edildi. MREler üzerinden zaman intensite eğrisi yoluyla semikantitatif parametreler olan maksimum kontrast enhansmanı, maksimum rölatif enhansman, wash-in oranı, tpeak, dinamik enhansman oranı, statik enhansman oranı, enhansman eğrisi, eğri altında kalan (AUC) alan hesaplandı. Bulgular: Aktif hastalıklı 17 hastanın toplam 43 bağırsak segmenti (26 tutulmuş, 17 normal) değerlendirildi. Tüm semikantitatif parametreler içinde sadece AUC tutulmuş ve normal bağırsak segmentleri arasında istatistiksel olarak anlamlı olarak farklı bulunmuştur. Sonuç: Bizim sonuçlarımız tek başına aktif enflamasyonu kolonoskopi ve patolojik doğrulamadan daha güvenilir olarak gösterebilecek semikantitatif bir parametrenin olmadığını göstermiştir.

Dinamik Kontrastlı Manyetik Rezonans Enterografinin Crohn Hastalığı Aktivitesi Tayinindeki Rolü

Objective: This study assessed the benefits of adding dynamic contrast-enhanced images to conventional magnetic resonance enterography (MRE) for detecting Crohns disease (CD) activity. Material and Method: The MRE images and files of 28 patients diagnosed with or suspected of having Crohns disease were reviewed. Colonoscopy was performed in all subjects. This study included 17 patients with both colonoscopic findings and histological evidence of active CD. All patients underwent dynamic contrast-enhanced MRE. The following semiquantitative parameters were derived from the time-intensity curve: the maximum contrast enhancement, maximum relative enhancement, wash-in rate, time to peak, dynamic and static enhancement ratios, slope of enhancement, and area under the curve (AUC). Results: In total, 43 bowel segments (26 involved, 17 normal) in the 17 patients with active disease were analyzed. Of the semiquantitative parameters, only the AUC differed significantly (p<0.05) between involved and normal bowel segments. Conclusion: No one semiquantitative parameter alone can identify active inflammation more reliably than colonoscopy and pathological confirmation.

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