Scholarlink

Objective <p>In Crohn’s disease (CD), noninflammatory strictures benefit from surgical resection or endoscopic dilatation, whereas inflammatory strictures might still respond to anti-inflammatory treatment. Therefore, it is crucial to determine whether a stricture is inflammatory or noninflammatory. We investigated whether magnetic resonance imaging (MRI) T2* and intravoxel incoherent motion (IVIM) parameters can distinguish inflammatory from noninflammatory strictures, using histopathology of location-matched surgical resection specimens as reference.</p> Materials and methods <p>CD patients scheduled for small bowel segment resection were included. MRI scans were acquired in 32 patients, including conventional anatomical T2*-weighted and DWI-IVIM sequences. The field of view was centred on the most significant small bowel stricture. T2* and IVIM parameters were compared with location-matched surgical resection specimens on histopathological sections, scored as inflammatory or noninflammatory. A Mann–Whitney <i>U</i> test (α = 0.01) was used to assess differences in MRI parameters between inflammatory and noninflammatory sections.</p> Results <p>Thirty-one patients (55% females) were analysed. Median T2*-value was significantly higher in inflammatory sections (25.4 ms [interquartile range 19.0‒33.1], <i>n</i> = 33) <i>versus</i> noninflammatory sections (18.6 ms [14.5‒27.8], <i>n</i> = 26) (<i>p</i> = 0.010). Diffusion coefficient was lower in inflammatory sections (0.0012 mm²/s [0.0010‒0.0014], <i>n</i> = 35) <i>versus</i> noninflammatory sections (0.0014 mm²/s [0.0011‒0.0019], <i>n</i> = 24) (<i>p</i> = 0.039). No significant differences were found in pseudodiffusion coefficient and pseudodiffusion signal fraction (0.06 mm²/s [0.03‒0.08] <i>versus</i> 0.06 mm²/s [0.03‒0.11], <i>p</i> = 0.926; 0.15 [0.09‒0.20] <i>versus</i> 0.18 [0.11‒0.24], <i>p</i> = 0.327).</p> Conclusion <p>A significantly higher T2*-value and a trend towards a lower diffusion coefficient were observed in inflammatory sections compared to noninflammatory sections in CD. External validation is needed.</p> Relevance statement <p>Higher T2*-value and lower IVIM diffusion coefficient could potentially serve as a biomarker in inflammatory stricture sections compared to noninflammatory sections in Crohn’s disease.</p> Trail registration <p>Dutch trial register NL9105: <a href="https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON54948">https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON54948</a>.</p> Key Points <p><UnorderedList Mark="Bullet"> <ItemContent> <p>T2* could serve as a biomarker for distinguishing inflammatory from noninflammatory strictures in Crohn’s disease.</p> </ItemContent> <ItemContent> <p>Diffusion measured by IVIM can distinguish inflammatory from noninflammatory strictures in Crohn’s disease.</p> </ItemContent> <ItemContent> <p>Muscularisation was more prominent than fibrosis in strictures due to Crohn’s disease.</p> </ItemContent> </UnorderedList></p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Utility of T2* and DWI-IVIM to distinguish inflammatory and noninflammatory strictures in Crohn’s disease: a prospective cross-sectional cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月22日

查看全文
  • Kim Johanna Beek,
  • Kyra van Rijn,
  • Floris de Voogd,
  • Nienke Petronella Maria Wassenaar,
  • Christianne Buskens,
  • Jarmila van der Bilt,
  • Willem Bemelman,
  • Geert Renaat D’Haens,
  • Krisztina Barbara Gecse,
  • Karin Horsthuis,
  • Jeroen Tielbeek,
  • Aart Mookhoek,
  • Andra Neefjes-Borst,
  • Oliver Gurney-Champion,
  • Jaap Stoker

摘要

Objective

In Crohn’s disease (CD), noninflammatory strictures benefit from surgical resection or endoscopic dilatation, whereas inflammatory strictures might still respond to anti-inflammatory treatment. Therefore, it is crucial to determine whether a stricture is inflammatory or noninflammatory. We investigated whether magnetic resonance imaging (MRI) T2* and intravoxel incoherent motion (IVIM) parameters can distinguish inflammatory from noninflammatory strictures, using histopathology of location-matched surgical resection specimens as reference.

Materials and methods

CD patients scheduled for small bowel segment resection were included. MRI scans were acquired in 32 patients, including conventional anatomical T2*-weighted and DWI-IVIM sequences. The field of view was centred on the most significant small bowel stricture. T2* and IVIM parameters were compared with location-matched surgical resection specimens on histopathological sections, scored as inflammatory or noninflammatory. A Mann–Whitney U test (α = 0.01) was used to assess differences in MRI parameters between inflammatory and noninflammatory sections.

Results

Thirty-one patients (55% females) were analysed. Median T2*-value was significantly higher in inflammatory sections (25.4 ms [interquartile range 19.0‒33.1], n = 33) versus noninflammatory sections (18.6 ms [14.5‒27.8], n = 26) (p = 0.010). Diffusion coefficient was lower in inflammatory sections (0.0012 mm²/s [0.0010‒0.0014], n = 35) versus noninflammatory sections (0.0014 mm²/s [0.0011‒0.0019], n = 24) (p = 0.039). No significant differences were found in pseudodiffusion coefficient and pseudodiffusion signal fraction (0.06 mm²/s [0.03‒0.08] versus 0.06 mm²/s [0.03‒0.11], p = 0.926; 0.15 [0.09‒0.20] versus 0.18 [0.11‒0.24], p = 0.327).

Conclusion

A significantly higher T2*-value and a trend towards a lower diffusion coefficient were observed in inflammatory sections compared to noninflammatory sections in CD. External validation is needed.

Relevance statement

Higher T2*-value and lower IVIM diffusion coefficient could potentially serve as a biomarker in inflammatory stricture sections compared to noninflammatory sections in Crohn’s disease.

Trail registration

Dutch trial register NL9105: https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON54948.

Key Points

T2* could serve as a biomarker for distinguishing inflammatory from noninflammatory strictures in Crohn’s disease.

Diffusion measured by IVIM can distinguish inflammatory from noninflammatory strictures in Crohn’s disease.

Muscularisation was more prominent than fibrosis in strictures due to Crohn’s disease.

Graphical Abstract