DIFFUSION WEIGHTED IMAGING VERSUS BOWEL SONOGRAPHY IN MONITORING THE RESPONSE TO BIOLOGICAL TREATMENT (ANTI TNF) IN CROHN’S DISEASE PATIENTS

Authors

1 Department of Tropical Medicine, Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University, Cairo 11566

2 Department of Radiology, Ain Shams University and MR Unit of Misr Radiology Center, Cairo, Egypt

Abstract

Crohn’s disease (CD) is a chronic relapsing granulomatous disease. It is characterized by transmural
inflammation of bowel walls and by skip lesions that may be found in any segment of the
gastro-intestinal (GI) tract. Radiological imaging plays a major role in the initial diagnosis of
small bowel Crohn’s disease (CD) and assessing the response to medical therapy or planning for
surgery, including the staging of complications of the disease.
This study assessed the value of diffusion weighted imaging (DWI) versus bowel sonography
(BS) obtained before and after treatment in detecting of healing in patients with CD treated with
biological treatment (anti-TNF). This study was conducted on 38 patients with active Crohn's
disease who received anti-TNF in IBD clinic in Ain Shams University Hospitals. After obtaining
informed consent from each patient, all were subjected to clinical assessment, laboratory investigations,
bowel ultrasound and DWI before and after biological treatment
BS results showed that the DWI accuracy in assessment of disease response after biologics
was 89.5% with 87.5% sensitivity & 100% specificity. Cut-off value of apparent diffusion coefficient
(ADC) to detect bowel segment activity was <=1.6 with sensitivity 90% & specificity
85.71%

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