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N004. A prospective comparison between 1.5 T magnetic resonance and 3 T magnetic resonance in ileo-colonic Crohn's disease: A single center experience

G. Fiorino1, C. Bonifacio2, M. Padrenostro2, F. Mrakic Sposta2, A. Repici3, A. Malesci4, L. Balzarini2, S. Danese1

1IRCCS Humanitas, IBD Unit, Rozzano, Italy; 2IRCCS Humanitas, Radiology, Rozzano, Italy; 3IRCCS Humanitas, Endoscopy Unit, Rozzano, Italy; 4IRCCS Humanitas, Gastroenterology, Rozzano, Italy

Aim: Crohn's disease (CD) is a chronic bowel disease that can affect mucosa and bowel wall. There is evidence that 1.5-T magnetic resonance (1.5T) is accurate to detect CD lesions and bowel wall affections of small intestine. 3.0 tesla magnetic resonance (3T) can increase signal-to-noise ratio (SNR) and reduces time of image acquisition (IAT), although data are still limited. There are not yet prospective data on the comparison between 3T and 1.5T in ileo-colonic CD.

Materials and Methods: To prospectively compare sensitivity, specificity and accuracy of 1.5T and 3T in patient with ileo-colonic CD, 32 patients (15 males, 17 female) with established ileo-colonic CD of any severity underwent 1.5T and 3T at the same time. Ileocolonoscopy was the reference standard for luminal disease. Peroral and intravenous contrast were administered to each patient. Sensitivity, specificity and accuracy in evaluating 5 signs of active disease (localization, wall thickening, wall enhancement, strictures, ulcers) were compared for both techniques. Statistical significance was set as p < 0.05.

Results: 3T resulted equally sensitive, specific and accurate compared to 1.5T in detecting localization of the disease (accuracy 0.86 vs 0.80), bowel wall thickening (accuracy 0.80 vs 0.80), bowel wall enhancement (0.68 vs 0.72) strictures (accuracy 0.92 vs 0.84). 3T resulted significantly superior to 1.5T in detecting mucosal lesions (accuracy 0.68 vs 0.57, p = 0.001).

3T showed higher SNR and faster IAT than 1.5 (15 minutes vs 30 minutes). Compliance of the patient due to shorter IAT was better for the 3T.

Conclusion: 3T is equally accurate as 1.5T in the evaluation of ileo-colonic CD. Because of superiority in detecting mucosal ulcers, increase of SNR and reduction of IAT as well as better patient's compliance, 3T should be used as preferred technique in patients with ileo-colonic CD when available.

1. Rimola J, Rodriguez S, García-Bosch O, Ordás I, Ayala E, Aceituno M, Pellisé M, Ayuso C, Ricart E, Donoso L, Panés J. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn's disease. Gut. 2009;58(8):1113–20.

2. Rimola J, Rodríguez S, García-Bosch O, Ricart E, Pagès M, Pellisé M, Ayuso C, Panés J. Role of 3.0-T MR colonography in the evaluation of inflammatory bowel disease. Radiographics. 2009 May-Jun;29(3):701–19.