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

Unni K. Udayasankar, Diego R Martin, Thomas Lauenstein, Robin Rutherford, John Galloway, Dana Tudorascu, Shanthi V. Sitaraman

Research output: Contribution to journalArticle

39 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1133-1140
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Volume28
Issue number5
DOIs
StatePublished - Nov 2008
Externally publishedYes

Fingerprint

Gadolinium
Inflammatory Bowel Diseases
Fats
Crohn Disease
Fibrosis
Inflammation

Keywords

  • Active disease
  • Crohn's disease
  • Small bowel MRI
  • SPAIR

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Role of spectral presaturation attenuated inversion-recovery fat-suppressed T2-weighted MR imaging in active inflammatory bowel disease. / Udayasankar, Unni K.; Martin, Diego R; Lauenstein, Thomas; Rutherford, Robin; Galloway, John; Tudorascu, Dana; Sitaraman, Shanthi V.

In: Journal of Magnetic Resonance Imaging, Vol. 28, No. 5, 11.2008, p. 1133-1140.

Research output: Contribution to journalArticle

Udayasankar, Unni K. ; Martin, Diego R ; Lauenstein, Thomas ; Rutherford, Robin ; Galloway, John ; Tudorascu, Dana ; Sitaraman, Shanthi V. / Role of spectral presaturation attenuated inversion-recovery fat-suppressed T2-weighted MR imaging in active inflammatory bowel disease. In: Journal of Magnetic Resonance Imaging. 2008 ; Vol. 28, No. 5. pp. 1133-1140.
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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.",
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AU - Lauenstein, Thomas

AU - Rutherford, Robin

AU - Galloway, John

AU - Tudorascu, Dana

AU - Sitaraman, Shanthi V.

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AB - 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.

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