Feasibility of Intestinal MR Elastography in Inflammatory Bowel Disease

Background While MR enterography allows detection of inflammatory bowel disease (IBD), the findings continue to be of limited use in guiding treatment-medication vs. surgery. Purpose To test the feasibility of MR elastography of the gut in healthy volunteers and IBD patients. Study Type Prospective pilot. Population Forty subjects (healthy volunteers: n = 20, 37 +/- 14 years, 10 women; IBD patients: n = 20 (ulcerative colitis n = 9, Crohn's disease n = 11), 41 +/- 15 years, 11 women). Field Strength/Sequence Multifrequency MR elastography using a single-shot spin-echo echo planar imaging sequence at 1.5 T with drive frequencies of 40, 50, 60, and 70 Hz. Assessment Maps of shear-wave speed (SWS, in m/s) and loss angle (phi, in rad), representing stiffness and solid-fluid behavior, respectively, were generated using tomoelastography data processing. Histopathological analysis of surgical specimens was used as reference standard in patients. Statistical Tests Unpaired t-test, one-way analysis of variance followed by Tukey post hoc analysis, Pearson's correlation coefficient and area under the receiver operating characteristic curve (AUC) with 95%-confidence interval (CI). Significance level of 5%. Results MR elastography was feasible in all 40 subjects (100% technical success rate). SWS and phi were significantly increased in IBD by 21% and 20% (IBD: 1.45 +/- 0.14 m/s and 0.78 +/- 0.12 rad; healthy volunteers: 1.20 +/- 0.14 m/s and 0.65 +/- 0.06 rad), whereas no significant differences were found between ulcerative colitis and Crohn's disease (P = 0.74 and 0.90, respectively). In a preliminary assessment, a high diagnostic accuracy in detecting IBD was suggested by an AUC of 0.90 (CI: 0.81-0.96) for SWS and 0.84 (CI: 0.71-0.95) for phi. Data Conclusion In this pilot study, our results demonstrated the feasibility of MR elastography of the gut and showed an excellent diagnostic performance in predicting IBD. Evidence Level 1 Technical Efficacy Stage 1

Automated summary

This study tested the feasibility of MR elastography of the gut in healthy volunteers and IBD patients, showing excellent diagnostic performance in predicting IBD.