Contrast-Enhanced MR Enterography as a Stand-Alone Tool to Evaluate Crohns Disease in Pediatric Population.

Bradley Spieler¹, Nicole Hindman¹, Caludia Reuben Seuss¹, Alec J. Megibow¹, Joseph Levy², Kerry Zabriskie², Daniel Sahlein¹, Rafael Rivera¹, Sooah Kim¹

MR imaging of the pediatric abdomen can be challenging, often secondary to inability to tolerate long scan times. Twenty five pediatric patients (mean age 11.2 years) with Crohns disease referred for MR enterography at 1.5 T were evaluated. Two radiologists reviewed post contrast images of MRI during the first session and all images including pre- and post contrast sequences during the second session. The intestine was divided into 10 segments. The readers evaluated the presence or absence of disease in regard to the presence of active inflammation using a five-point grading system. Sensitivity, specificity, PPV, NPV, and accuracy for diagnosing definite active inflammation using post contrast images alone were 83.3%, 86.9%, 89.3%, 80%, and 84.9%, respectively. In all five of the false negative cases there was a disagreement in at least one bowel segment with respect to the presence or absence of abscess and/or sinus tracts which was confirmed on non-contrast images (HASTE without fat suppression).