The Value Of Magnetic Resonance Imaging In The Diagnosis And Evaluation Of Inflammatory Bowel Disease Score

Objective:To investigate the diagnostic efficiency of each MRI index for inflammatory bowel disease（IBD）by magnetic resonance imaging（MRI）plain scan and enhancement combined with diffusion-weighted imaging（DWI）.Secondly,to study the value of each MRI index in the quantitative evaluation of IBD inflammation.Methods:14 patients with pathologically diagnosed IBD were collected.No bowel preparation was performed in 48h during colonoscopy.Intestinal 3.0T MR plain scan,DWI and enhanced scan were performed.Additionally,10 normal volunteers were examined by plain scan.By experienced radiologists on abdominal MR scan,enhancement,DWI and ADC map analysis,MR segmental score for each intestinal segment（MR-score-S）,and the measurement of each segment of intestine（rectum,sigmoid colon,descending colon,transverse colon,ascending colon and ileum）ADC and intestinal wall thickness.Based on the gold standard of endoscopy,the ADC value,intestinal wall thickness and MR-score-S diagnosis of IBD were analyzed by ROC curve.At the same time,the cut-off values of IBD were calculated by MR-score-S,ADC and intestinal wall thickness,and the correlation between MR-score-S,ADC value,intestinal wall thickness and IBD endoscopic grading was analyzed.Results:116 intestinal segments of 14 patients and 10 normal volunteers were analyzed.The analysis of ROC curve,MR-score-S,ADC value area of ROC curve and the thickness of the bowel wall and the diagnosis of IBD were 0.8126,0.7654 and0.74;MR-score-S（Without enhancement）,MR-score-S（Without DWI）and MR-score-S（Without enhancement and DWI）area under the curve were 0.785,0.7988 and 0.7377.When the Youden index of the MR scoring index was 0.578,the sensitivity and specificity of the detection of IBD were 66.7%,91.1%and 1.5respectively,respectively.When the ADC value of the Youden index is 0.436,the detection sensitivity and specificity of IBD were 53.6%,90%,cut-off=1.55×10^-3mm²/s;and the thickness of the bowel wall Youden index is 0.416,the detection sensitivity and specificity of IBD were 62.5%,79.1%,cut-off value 0.435cm;in IBD patients,MR score,ADC value and the correlation between intestinal wall thickness and IBD endoscopic grading were statistically significant（P<0.05）,which in the case of UC,the correlation coefficient MR-score-S,ADC value,bowel wall thickness and endoscopic results were 0.724,0.519 and-0.43;and the correlation coefficient of MR-score-S in CD patients,ADC value,bowel wall thickness and endoscopic results were 0.484,0.331 and-0.392.The Pearson’s correlation coefficient of the ADC measured by two radiologists was 0.966（P<0.01）.Conclusion:Conventional MRI scan,combined with enhanced and diffusion weighted（DWI）as a non-invasive examination method,provides a new diagnostic method for the diagnosis of patients with inflammatory bowel disease,combined with DWI and enhanced diagnosis can provide higher performance,and by quantitative assessment of disease severity of intestinal inflammation,especially in ulcerative colitis,to guide clinical individualized treatment and improve the prognosis of IBD.