A novel identification system combining diffusion kurtosis imaging with conventional magnetic resonance imaging to asses
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A novel identification system combining diffusion kurtosis imaging with conventional magnetic resonance imaging to assess intestinal strictures in patients with Crohn’s disease Jin‑fang Du1 · Bao‑lan Lu1 · Si‑yun Huang1 · Ren Mao2 · Zhong‑wei Zhang3 · Qing‑hua Cao4 · Zhi‑hui Chen5 · Shuo‑yang Li6 · Qing‑lian Qin7 · Can‑hui Sun1 · Shi‑ting Feng1 · Zi‑ping Li1 · Li Huang1 · Xue‑hua Li1 Received: 14 May 2020 / Revised: 4 September 2020 / Accepted: 10 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To determine the utility of diffusion kurtosis imaging (DKI) for assessing bowel fibrosis and to establish a new magnetic resonance imaging (MRI)-based classification based on DKI and conventional MRI parameters for characterizing intestinal strictures in Crohn’s disease (CD) using the histological evaluation of resected intestine samples as the reference standard. Methods Thirty-one patients with CD undergoing preoperative conventional MRI and diffusion-weighted imaging (DWI) (b values = 0–2000 s/mm2) were consecutively enrolled. We classified the mural T2-weighted signal intensity and arterialphase enhancement patterns on conventional MRI. We also measured DWI-derived apparent diffusion coefficients (ADCs) and DKI-derived apparent diffusion for non-Gaussian distribution (D app) and apparent diffusional kurtosis (Kapp). A new MRI-based classification was established to characterize intestinal strictures in CD. Its performance was validated in nine additional patients with CD. Results Histological inflammation grades were significantly correlated to T2-weighted signal intensity (r = 0.477; P
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