Abstract 88: MR Imaging Assessment of Crohn's Disease Activity, Using Fat-suppressed T2-weighted Turbo Spin-Echo Sequences with a Negative Oral Contrast Material
AUTHORS:
F. Maccioni, MD, I. Carbone, MD, A. Viscido, MD, A. Ascarelli, MD, G. Marcelli, MD, P. Rossi, MD.
ABSTRACT:
PURPOSE: To demonstrate the value of fat-suppressed T2 weighted MRI in the assessment of Crohn's Disease (CD) activity, after oral administration of a superparamagnetic contrast material. Suppression of the high signal of the perivisceral fat tissue and of the hyperintensity of the luminal content should cause the T2-signal of the inflamed wall to be maximally enhanced.
METHOD AND MATERIALS: Twenty patients with CD underwent MRI after oral administration of iron oxide particles (Lumirem, Guerbet). Fat-suppressed T2-weighted Turbo Spin Echo (TSE) images were acquired through the abdomen and pelvis; for comparison, T2-weighted TSE and T1-weighted Turbo Field Echo (TFE) images pre and post Gd-DTPA injection were obtained. The following MRI findings were considered: wall T2-signal and enhancement, fibrofatty proliferation (FFP) T2-signal and enhancement, local lymph nodes T2-signal and enhancement, perivisceral fluid collections. Clinical activity was monitored by means of clinical indexes, laboratory tests and endoscopic examination.All MRI data were evaluated by two radiologists with no knowledge of the clinical and endoscopic results.
RESULTS: Fourteen patients had clinically active CD. In this group of patients fat-suppressed T2-weighted TSE images showed more abnormalities than non suppressed T2-weighted TSE (p< 0.00001). High FFP T2-signal on fat-suppressed images was strongly correlated with active disease (p< 0.00001). Non active CD did not show T2-modifications.
CONCLUSIONS: Orally contrasted T2-weighted fat-suppressed TSE images are extremely sensitive in the evaluation of bowel inflammation and comparable to contrast-enhanced ones. They can be used alone in the assessment of CD activity, thus reducing costs and time of the MRI examinations.
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