Vinicius de Padua V. Alves, Neeraja Mahalingam, Jean A. Tkach, Alexander J. Towbin, Rebecca Imbus, Lee A. Denson, Jonathan R. Dillman
{"title":"新诊断为小肠克罗恩病的儿童和年轻成人患者肠道磁共振成像体外不连贯运动的前瞻性特征。","authors":"Vinicius de Padua V. Alves, Neeraja Mahalingam, Jean A. Tkach, Alexander J. Towbin, Rebecca Imbus, Lee A. Denson, Jonathan R. Dillman","doi":"10.1007/s00261-024-04318-4","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>MRI diffusion-weighted imaging (DWI) is commonly used in MR enterography protocols for assessment of intestinal inflammation in patients with Crohn’s disease. The intravoxel incoherent motion (IVIM) approach to DWI has been proposed as a more objective approach, providing quantitative parameters that reflect water diffusivity (<i>D</i>), blood flow (<i>D*</i>), and perfusion fraction (<i>f</i>).</p><h3>Purpose</h3><p>We aimed to determine if DWI-IVIM metrics from the terminal ileum in patients with newly diagnosed Crohn’s disease differ from healthy participants and change in response to biologic medical therapy.</p><h3>Methods</h3><p>In this prospective case–control study, 20 consecutive pediatric patients (mean age = 14 years ± 2 [SD]; eight females) with newly diagnosed ileal Crohn’s disease and 15 pediatric healthy participants (mean age = 18 years ± 4 [SD]; eight females) underwent research MRI examinations of the small bowel between 12/2018 and 10/2021. Participants with Crohn's disease underwent MR studies at baseline, 6 weeks, and 6 months following initiation of anti-TNF-alpha therapy, whereas control participants underwent one research MRI examination. The MRI protocol included a DWI-IVIM sequence with nine b-values and the IVIM parameters (<i>D</i>, <i>D*</i>, and <i>f</i>) were extracted. Unpaired t-tests and mixed-effects models were used for analyses.</p><h3>Results</h3><p>Mean IVIM <i>D</i> (<i>P</i> < 0.001), <i>D*</i> (<i>P</i> = 0.004), and <i>f</i> (<i>P</i> = 0.001) metrics were lower for Crohn’s patients at the time of diagnosis compared to healthy participants. Mean IVIM <i>f</i> value increased over time in response to medical therapy (mean <i>f</i> at baseline, 22% ± 6%; 6 weeks, 25% ± 7%; 6 months, 29% ± 10%; <i>P</i> = 0.016). Mean IVIM <i>D*</i> value increased over time in response to treatment (mean <i>D*</i> at baseline, 10.9 ± 3.0 × 10<sup>−3</sup> mm<sup>2</sup>/s; 6 weeks, 11.8 ± 2.8 × 10<sup>−3</sup> mm<sup>2</sup>/s; 6 months, 13.3 ± 3.3 × 10<sup>−3</sup> mm<sup>2</sup>/s; <i>P</i> = 0.047), while there was no significant change in mean IVIM <i>D</i> value (<i>P</i> = 0.10).</p><h3>Conclusion</h3><p>MRI DWI-IVIM metrics in patients with ileal Crohn’s disease change over time in response to biological therapy and help discriminate these patients from healthy participants.</p><h3>Graphical abstract</h3>\n<div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prospective characterization of intestinal MRI intravoxel incoherent motion in pediatric and young adult patients with newly diagnosed small bowel Crohn’s disease\",\"authors\":\"Vinicius de Padua V. Alves, Neeraja Mahalingam, Jean A. Tkach, Alexander J. Towbin, Rebecca Imbus, Lee A. Denson, Jonathan R. Dillman\",\"doi\":\"10.1007/s00261-024-04318-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>MRI diffusion-weighted imaging (DWI) is commonly used in MR enterography protocols for assessment of intestinal inflammation in patients with Crohn’s disease. The intravoxel incoherent motion (IVIM) approach to DWI has been proposed as a more objective approach, providing quantitative parameters that reflect water diffusivity (<i>D</i>), blood flow (<i>D*</i>), and perfusion fraction (<i>f</i>).</p><h3>Purpose</h3><p>We aimed to determine if DWI-IVIM metrics from the terminal ileum in patients with newly diagnosed Crohn’s disease differ from healthy participants and change in response to biologic medical therapy.</p><h3>Methods</h3><p>In this prospective case–control study, 20 consecutive pediatric patients (mean age = 14 years ± 2 [SD]; eight females) with newly diagnosed ileal Crohn’s disease and 15 pediatric healthy participants (mean age = 18 years ± 4 [SD]; eight females) underwent research MRI examinations of the small bowel between 12/2018 and 10/2021. Participants with Crohn's disease underwent MR studies at baseline, 6 weeks, and 6 months following initiation of anti-TNF-alpha therapy, whereas control participants underwent one research MRI examination. The MRI protocol included a DWI-IVIM sequence with nine b-values and the IVIM parameters (<i>D</i>, <i>D*</i>, and <i>f</i>) were extracted. Unpaired t-tests and mixed-effects models were used for analyses.</p><h3>Results</h3><p>Mean IVIM <i>D</i> (<i>P</i> < 0.001), <i>D*</i> (<i>P</i> = 0.004), and <i>f</i> (<i>P</i> = 0.001) metrics were lower for Crohn’s patients at the time of diagnosis compared to healthy participants. Mean IVIM <i>f</i> value increased over time in response to medical therapy (mean <i>f</i> at baseline, 22% ± 6%; 6 weeks, 25% ± 7%; 6 months, 29% ± 10%; <i>P</i> = 0.016). Mean IVIM <i>D*</i> value increased over time in response to treatment (mean <i>D*</i> at baseline, 10.9 ± 3.0 × 10<sup>−3</sup> mm<sup>2</sup>/s; 6 weeks, 11.8 ± 2.8 × 10<sup>−3</sup> mm<sup>2</sup>/s; 6 months, 13.3 ± 3.3 × 10<sup>−3</sup> mm<sup>2</sup>/s; <i>P</i> = 0.047), while there was no significant change in mean IVIM <i>D</i> value (<i>P</i> = 0.10).</p><h3>Conclusion</h3><p>MRI DWI-IVIM metrics in patients with ileal Crohn’s disease change over time in response to biological therapy and help discriminate these patients from healthy participants.</p><h3>Graphical abstract</h3>\\n<div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>\",\"PeriodicalId\":7126,\"journal\":{\"name\":\"Abdominal Radiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Abdominal Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s00261-024-04318-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Abdominal Radiology","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s00261-024-04318-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Prospective characterization of intestinal MRI intravoxel incoherent motion in pediatric and young adult patients with newly diagnosed small bowel Crohn’s disease
Background
MRI diffusion-weighted imaging (DWI) is commonly used in MR enterography protocols for assessment of intestinal inflammation in patients with Crohn’s disease. The intravoxel incoherent motion (IVIM) approach to DWI has been proposed as a more objective approach, providing quantitative parameters that reflect water diffusivity (D), blood flow (D*), and perfusion fraction (f).
Purpose
We aimed to determine if DWI-IVIM metrics from the terminal ileum in patients with newly diagnosed Crohn’s disease differ from healthy participants and change in response to biologic medical therapy.
Methods
In this prospective case–control study, 20 consecutive pediatric patients (mean age = 14 years ± 2 [SD]; eight females) with newly diagnosed ileal Crohn’s disease and 15 pediatric healthy participants (mean age = 18 years ± 4 [SD]; eight females) underwent research MRI examinations of the small bowel between 12/2018 and 10/2021. Participants with Crohn's disease underwent MR studies at baseline, 6 weeks, and 6 months following initiation of anti-TNF-alpha therapy, whereas control participants underwent one research MRI examination. The MRI protocol included a DWI-IVIM sequence with nine b-values and the IVIM parameters (D, D*, and f) were extracted. Unpaired t-tests and mixed-effects models were used for analyses.
Results
Mean IVIM D (P < 0.001), D* (P = 0.004), and f (P = 0.001) metrics were lower for Crohn’s patients at the time of diagnosis compared to healthy participants. Mean IVIM f value increased over time in response to medical therapy (mean f at baseline, 22% ± 6%; 6 weeks, 25% ± 7%; 6 months, 29% ± 10%; P = 0.016). Mean IVIM D* value increased over time in response to treatment (mean D* at baseline, 10.9 ± 3.0 × 10−3 mm2/s; 6 weeks, 11.8 ± 2.8 × 10−3 mm2/s; 6 months, 13.3 ± 3.3 × 10−3 mm2/s; P = 0.047), while there was no significant change in mean IVIM D value (P = 0.10).
Conclusion
MRI DWI-IVIM metrics in patients with ileal Crohn’s disease change over time in response to biological therapy and help discriminate these patients from healthy participants.
期刊介绍：
Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section.
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Asian Society of Abdominal Radiology (ASAR)
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