Purpose: The added value of diffusion weighted imaging (DWI) for detection of inflammation in Crohn’s disease (CD) has been examined previously. However, its use in the evaluation of jejunal inflammation related to CD is uncommon. In this study we compared DWI, video capsule endoscopy (VCE), and inflammatory biomarkers in the assessment of CD involving the jejunum.
Methods: CD patients in clinical remission were prospectively recruited and underwent MR-enterography (MRE) and VCE. C-reactive protein (CRP) and fecal calprotectin (FCP) levels were obtained. MREs were evaluated for restricted diffusion (presence/absence) and apparent diffusion coefficient (ADC) measurements were obtained. The VCE based Lewis score was calculated. Associations between DWI, ADC, Lewis score, and inflammatory biomarkers were evaluated.
Results: This study included 51 patients were included. 27/51 (52.9%) of VCEs showed jejunal mucosal inflammation. Sensitivity and specificity of restricted diffusion for mucosal inflammation as determined by VCE were 59.3% and 37.5% for the 1st reader and 66.7% and 37.5% for the 2nd reader, respectively. DWI was not statistically associated with mucosal inflammation in the jejunum (p=0.813). ADC did not correlate with jejunal Lewis score (R=-0.091), or with inflammatory biomarkers (CRP: R=0.088; FCP: R=0.196).
Conclusion: DWI parameters were not associated with either VCE mucosal inflammation or with inflammatory biomarkers in jejunal evaluation for CD.
