Multi-shot Diffusion-Weighted MRI With Multiplexed Sensitivity Encoding (MUSE) in the Assessment of Active Inflammation in Crohn's Disease
Journal
Journal of Magnetic Resonance Imaging
Journal Volume
55
Journal Issue
1
Pages
126-137
Date Issued
2022
Author(s)
Chang H.-C
Abstract
Background: Single-shot diffusion-weighted imaging (ssDWI) has been shown useful for detecting active bowel inflammation in Crohn's disease (CD) without MRI contrast. However, ssDWI suffers from geometric distortion and low spatial resolution. Purpose: To compare conventional ssDWI with higher-resolution ssDWI (HR-ssDWI) and multi-shot DWI based on multiplexed sensitivity encoding (MUSE-DWI) for evaluating bowel inflammation in CD, using contrast-enhanced MR imaging (CE-MRI) as the reference standard. Study Type: Prospective. Subjects: Eighty nine patients with histological diagnosis of CD from previous endoscopy (55 male/34 female, age: 17–69 years). Field Strength/Sequences: ssDWI (2.7 mm × 2.7 mm), HR-ssDWI (1.8 mm × 1.8 mm), MUSE-DWI (1.8 mm × 1.8 mm) based on echo-planar imaging, T2-weighted imaging, and CE-MRI sequences, all at 1.5 T. Assessment: Five raters independently evaluated the tissue texture conspicuity, geometry accuracy, minimization of artifacts, diagnostic confidence, and overall image quality using 5-point Likert scales. The diagnostic performance (sensitivity, specificity and accuracy) of each DWI sequences was assessed on per-bowel-segment basis. Statistical Tests: Inter-rater agreement for qualitative evaluation of each parameter was measured by the intra-class correlation coefficient (ICC). Paired Wilcoxon signed-rank tests were performed to evaluate the statistical significance of differences in qualitative scoring between DWI sequences. A P value <0.05 was considered to be statistically significant. Results: Tissue texture conspicuity, geometric distortions, and overall image quality were significantly better for MUSE-DWI than for ssDWI and HR-ssDWI with good agreement among five raters (ICC: 0.70–0.89). HR-ssDWI showed significantly poorer performance to ssDWI and MUSE-DWI for all qualitative scores and had the worst diagnostic performance (sensitivity of 57.0% and accuracy of 87.3%, with 36 undiagnosable cases due to severe artifacts). MUSE-DWI showed significantly higher sensitivity (97.5% vs. 86.1%) and accuracy (98.9% vs. 95.1%) than ssDWI for detecting bowel inflammation. Data Conclusion: MUSE-DWI was advantageous in assessing bowel inflammation in CD, resulting in improved spatial resolution and image quality. Level of Evidence: 2. Technical Efficacy Stage: 2. ? 2021 International Society for Magnetic Resonance in Medicine
Subjects
active bowel inflammation
Crohn's disease
diffusion-weighted imaging
multi-shot diffusion-weighted imaging
multiplexed sensitivity encoding
adolescent
adult
aged
Crohn disease
diagnostic imaging
diffusion weighted imaging
female
human
inflammation
male
middle aged
nuclear magnetic resonance imaging
prospective study
young adult
Adolescent
Adult
Aged
Crohn Disease
Diffusion Magnetic Resonance Imaging
Female
Humans
Inflammation
Magnetic Resonance Imaging
Male
Middle Aged
Prospective Studies
Young Adult
SDGs
Type
journal article