Crohn's on the Radar

Testing for Crohns can be done fast and efficiently with diffusion-weight imaging

December 16, 2012 / Author:  / Reviewed by: Chris Galloway, M.D.

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(dailyRx News) The last thing anyone with stomach issues wants to do is get poked in order to find out what's wrong. And, since moving is not allowed when getting an MRI, other imaging techniques might help.

Diffusion-weighted imaging (DWI) provides quality and comprehensive images quickly to diagnose Crohn's disease without any extra prodding, according to new research.

This method may be a faster and easier way to test patients for Crohn's in the future, researchers said.

"Ask your doctor about ways to test for Crohn's."

Diffusion-weighted imaging shows how water is spread throughout the area of the body being examined. Images are brought up quickly and allow the patient to breathe freely while being scanned, without the need of IV contrast medication that has been used to enhance images.

The aim of the study, led by Henning Neubauer, from the Institute of Radiology at the University Hospital Wuerzburg in Germany, was to see how well DWI worked in figuring out if patients of all ages have Crohn's disease, compared to contrast enhanced magnetic resonance imaging (MRI), which images the intestines with the aid of intravenous contrast to aid resolution.

The study included 33 young adults and children, who averaged about 17 years of age and had been diagnosed with the stomach problem. Most were diagnosed before the study and had the stomach problem between three months and almost 12 years.

Each patient had an MRI and diffusion-weighted images of their small bowels after fasting for several hours. To compare results, 27 similar individuals with other stomach issues also underwent the two tests. In addition, about two-thirds of all the patients had a colonoscopy to double-check the results.

The DWI correctly identified 32 patients with Crohn's, compared to 31 patients with the MRI tests, researchers found. The imaging system also detected all 22 of the lesions in the small bowels and other complications with Crohn's.

In two of the patients, a part of the large intestine collapsed, which caused the DWI and MRI to incorrectly identify two Crohn's cases. The patients without Crohn's were not misidentified.

Both imaging methods were able to show inflammation in the walls of the small intestine, however the DWI was better able to show lesions in 27 percent of the bowel sections measured.

But in its ability to show contrasting images, DWI was only about 71 percent equal to the image quality of contrast enhanced MRIs.

DWI "has potential as a stand-alone imaging technique for the diagnostic workup in children and young adults with known or suspected Crohn's disease," the authors wrote in their report.

"A streamlined scanning protocol including DWI in free-breathing mode and fast T2-weighted imaging is likely to result in better patient compliance, and therefore improved image quality, particularly in young patients in a poor clinical condition," they wrote.

The authors, who have no conflicts of interest to declare, note that symptom information from the Crohn's patients was missing or incomplete, which limited their ability to compare the two imaging techniques.

With the small study size, it's unclear whether the quality of the imaging techniques would apply to a larger population, and the DWI was limited in its spatial capability.

The study was published online December 5 in the journal Pediatric Radiology. Funding information was not available.