Diffusion-weighted bowel imaging improves diagnostic confidence

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 - DWI
A 16-year-old female patient with Crohn's disease and inflammatory changes at the terminal ileum (arrow).
Source: Clinical Radiology 2014;69:372-377

Diffusion-weighted imaging of the bowel offers additional information for the reader and thereby improves diagnostic confidence, according to a study published in the April issue of Clinical Radiology.

Though MRI is mainly used for evaluation of inflammatory and tumor diseases of the bowel, diagnostic confidence is constrained. However, diffusion-weighted imaging has recently shown promise as a screening technique for the whole body as well as abdominal MRI. Lead author Sonja Kinner, MD, of the University Hospital Essen in Germany, and colleagues sought to determine if the addition of diffusion-weighted imaging improved the diagnostic confidence of bowel MRI.

The study included 111 patients who were scheduled for MR enterography or colonoscopy due to suspected inflammatory or tumor bowel disease. Data were collected from T2-weighted, contrast-enhanced T1-weighted, and axial and coronal diffusion-weighted sequences. Diagnostic confidence was evaluated with a four-point Likert scale.

Results revealed that 11 of the 111 patients had improved diagnostic confidence by the diffusion-weighted imaging. Readers changed their diagnoses from “probable” to “certain presence of lesions” in seven patients. In four other patients, lesions that were not depicted with the T1 or T2-weighted imaging were diagnosed with diffusion-weighted imaging.

“In conclusion, additional DWI sequences enhance diagnostic confidence or even provide additional information in patients undergoing MRI of the bowel. DWI can be routinely performed with every bowel MRI examination, as it can be of value for patients with known or suspected diseases of the intestine and can be performed and evaluated in an acceptable time,” wrote Kinner and colleagues.