Quantitative evaluation of Crohn's disease using dynamic contrast-enhanced MRI in children and young adults

Objectives To evaluate the clinical usefulness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in children and young adults with Crohn's disease. Methods From August 2017 to October 2018, 30 patients with Crohn's disease (21 males and 9 females; mean age 15.1 +/- 2.5 years) underwent DCE-MRI with MRI enterography. We assessed the endoscopic finding, pediatric Crohn's disease activity index (PCDAI), C-reactive protein (CRP) level (mg/dL), Crohn's disease MR index (CDMI) score, and the perfusion parameters of DCE-MRI (K-trans, K-ep, and V-e) at the ileocecal region between the inactive and active groups based on the histopathologic status. Results The active Crohn's disease group showed higher PCDAI, CRP, and CDMI scores than the inactive group (22.2 +/- 18.8 vs. 6.3 +/- 6.4, p = 0.027; 1.32 +/- 1.79 vs. 0.10 +/- 0.13, p = 0.005; 7.4 +/- 3.9 vs. 4.5 +/- 3.0, p = 0.047, respectively). The active Crohn's disease group showed a higher K-trans value than the inactive group (0.31 +/- 0.12 vs. 0.16 +/- 0.46 min(-1), p = 0.002). Endoscopic finding; PCDAI, CRP, and CDMI scores; and K-trans value were significant parameters in the identification of the active Crohn's disease (p = 0.002, p < 0.001, p = 0.029, p = 0.006, and p < 0.001, respectively). K-trans value was the most significant value for identifying active Crohn's disease in the multivariate logistic regression analysis (p = 0.013). Conclusion K-trans value could discriminate between inactive and active Crohn's diseases. K-trans value may have the potential to monitor the pediatric Crohn's disease activity.