TITLE:
Color Doppler Ultrasonography and Diffusion Weighted Magnetic Resonance Enterography in Pediatric Ibd: Comparison with Histology in the Evaluation of Disease Severity
AUTHORS:
Salinaro Emanuela, Mancini Maria Elisabetta, De Venuto Domenica, Gallone Maria Filomena, Russo Silvana, Monteduro Mariantonietta, Angelelli Giuseppe
KEYWORDS:
Pediatric IBD, Crohn Disease, Ulcerative Colitis, Bowel Ultrasonography, Magnetic Resonance En-terography, Disease Activity, Diffusion Weighted Imaging, Radiation Exposure
JOURNAL NAME:
Open Access Library Journal,
Vol.3 No.2,
February
25,
2016
ABSTRACT:
Objectives: The purpose of this study was to retrospectively compare color
Doppler Ultrasonography (CD-US) and diffusion weighted Magnetic Resonance Enterography
(DWI-MRE) in the evaluation of disease severity of pediatric inflammatory bowel
diseases (IBD). Materials and methods: During the period between February 2010 and
November 2012, 36 patients affected by IBD, aged between 7.8 and 18.5 years (mean
11.9 years) underwent, in the same week, CD-US, DWI-MRE [completed by apparent diffusion
coefficient (ADC) calculation] and ileocolonoscopy with intestinal biopsies. Overall,
53 bowel segments (27 ileal, 26 colonic) were examined. At CD-US evaluation, a wall
thickness > 3 mm in the small bowel and >2 mm in the large bowel, associated
with an increased intramural vascularity, were considered abnormal. ADC values were
significant when lower than 2 × 10﹣3 mm2/sec. Histopathological
grading of inflammation distinguished between active (mild, moderate and severe)
and inactive disease. For each segment, CD-US findings and ADC values were compared
with histology. Results: CD-US correctly graded 46/53 cases (86.8%) as compared
with histology. Statistical analysis demonstrated a negative correlation between
ADC and histology, with the results corresponding in 43/53 cases (81.1%). Conclusions:
Our study shows that both CD-US and DWI-MRE are non-invasive, useful diagnostic
tools for the grading of IBD activity in children.