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Quantitative evaluation of Crohn’s disease using dynamic contrast-enhanced MRI in children and young adults

  • Paediatric
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Abstract

Objectives

To evaluate the clinical usefulness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in children and young adults with Crohn’s disease.

Methods

From August 2017 to October 2018, 30 patients with Crohn’s disease (21 males and 9 females; mean age 15.1 ± 2.5 years) underwent DCE-MRI with MRI enterography. We assessed the endoscopic finding, pediatric Crohn’s disease activity index (PCDAI), C-reactive protein (CRP) level (mg/dL), Crohn’s disease MR index (CDMI) score, and the perfusion parameters of DCE-MRI (Ktrans, Kep, and Ve) at the ileocecal region between the inactive and active groups based on the histopathologic status.

Results

The active Crohn’s disease group showed higher PCDAI, CRP, and CDMI scores than the inactive group (22.2 ± 18.8 vs. 6.3 ± 6.4, p = 0.027; 1.32 ± 1.79 vs. 0.10 ± 0.13, p = 0.005; 7.4 ± 3.9 vs. 4.5 ± 3.0, p = 0.047, respectively). The active Crohn’s disease group showed a higher Ktrans value than the inactive group (0.31  ±  0.12 vs. 0.16 ±  0.46 min−1, p = 0.002). Endoscopic finding; PCDAI, CRP, and CDMI scores; and Ktrans value were significant parameters in the identification of the active Crohn’s disease (p = 0.002, p < 0.001, p = 0.029, p = 0.006, and p < 0.001, respectively). Ktrans value was the most significant value for identifying active Crohn’s disease in the multivariate logistic regression analysis (p = 0.013).

Conclusion

Ktrans value could discriminate between inactive and active Crohn’s diseases. Ktrans value may have the potential to monitor the pediatric Crohn’s disease activity.

Key Points

• With dynamic contrast-enhanced MRI, we can quantitatively monitor the Crohn’s disease status in pediatric patients and provide proper management plans to clinicians.

• The K trans value of dynamic contrast-enhanced MRI perfusion parameter, as well as the clinical pediatric Crohn’s disease activity index, C-reactive protein level, the endoscopic score, and the Crohn’s disease MR index, was higher in the active Crohn’s disease than in the inactive group based on the histopathologic status.

• The K trans value among the dynamic contrast-enhanced MRI perfusion parameters was the most significant differentiating parameter for the active Crohn’s disease from inactive status among those parameters (p = 0.013).

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Abbreviations

CDMI:

Crohn’s disease magnetic resonance imaging index

CRP:

C-reactive protein

DCE-MRI:

Dynamic contrast-enhanced magnetic resonance imaging

K ep :

Rate constant

K trans :

Volume transfer coefficient

MRE:

Magnetic resonance enterography

PCDAI:

Pediatric Crohn’s disease activity index

TIC:

Time-intensity curve

V e :

Extracellular extravascular volume fraction

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Seunghyun Lee, Young Hun Choi, Yeon ** Cho, Jung-Eun Cheon & Woo Sun Kim

  2. Department of Radiology, Seoul National University College of Medicine (Baltimore), 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Young Hun Choi, Jung-Eun Cheon & Woo Sun Kim

  3. Institute of Radiation Medicine (Baltimore), Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Jung-Eun Cheon & Woo Sun Kim

  4. Department of Pediatrics, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    ** Soo Moon

  5. Department of Pathology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Gyeong Hoon Kang

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  1. Seunghyun Lee
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Corresponding author

Correspondence to Young Hun Choi.

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The scientific guarantor of this publication is Young Hun Choi.

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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Seunghyun Lee and Young Hun Choi have significant statistical expertise.

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Lee, S., Choi, Y.H., Cho, Y.J. et al. Quantitative evaluation of Crohn’s disease using dynamic contrast-enhanced MRI in children and young adults. Eur Radiol 30, 3168–3177 (2020). https://doi.org/10.1007/s00330-020-06684-1

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  • DOI: https://doi.org/10.1007/s00330-020-06684-1

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