programma & abstracts - Nederlandse Vereniging voor Radiologie

Sessie 7
Kinderradiologie/Diversen 7
Kinderradiologie/Diversen
Vrijdag 30 september, 10.45 - 12.15 uur
O7.1
THE ROLE OF DYNAMIC CONTRAST
ENHANCED MR ENTEROGRAPHY AS
COMPARED TO ABDOMINAL ULTRASOUND
IN DIAGNOSING INFLAMMATORY BOWEL
DISEASE IN CHILDREN
M.L.W. Ziech, T.Z. Hummel, A.M. Smets, C. Lavini,
A. Kindermann, S. Bipat, A.J. Nederveen, M.W.A. Caan,
J. Stoker
Academisch Medisch Centrum, Amsterdam
Purpose: Our purpose was to assess if dynamic contrast
enhanced magnetic resonance imaging is useful as compared
to ultrasound in diagnosing inflammatory bowel disease
(IBD) in children.
Method and materials: Consecutive consenting pediatric
patients with suspected IBD were included. All patients
underwent diagnostic work-up including ileo-colonoscopy
and esophagogastroduodenoscopy under general anesthesia,
MR enterography (800 ml sorbitol ingested in 3 hours
as an small bowel and colonic intraluminal contrast agent,
3T coronal dynamic contrast enhanced 3D T1-weighted
sequence, temporal resolution 0.8 seconds) and
abdominal ultrasound (including Doppler measurements of
the superior and inferior mesenteric artery). At MRI maximum
enhancement (ME) was calculated in a region of interest
representing the terminal ileum, ascending, transverse
and descending colon. Statistical analysis was performed
with the Kruskall-Wallis test.
Results: Eighteen paediatric patients were included (9
males, 50%; mean age 14, range 10-18 years). Seven were
diagnosed with ulcerative colitis (39%) and eight with
Crohn’s disease (44%). Three patients had no IBD (17%).
Fifteen patients underwent all modalities, three did not
undergo ultrasound. Patients with Crohn’s disease had significantly
larger wall thickness of the terminal ileum (p=0.037)
measured with abdominal ultrasound. There were no differences
between groups for all other segments and flow
velocities. Mean ME at DCE-MRI did not differ significantly
between the three groups (p=0.202).
Conclusion: Wall thickness of the terminal ileum on abdominal
ultrasound can be used for the diagnosing Crohn’s
disease, but not for ulcerative colitis. There seems to be no
role for DCE-MRI in children with suspected IBD.
O7.2
MINIMALLY INVASIVE MRI BY OMITTING
INTRAVENOUS CONTRAST INJECTION;
DOES IT CHANGE THE RADIOLOGIC
ASSESSMENT OF KNEE JOINT PATHOLOGIES
IN JIA?
R. Hemke, M.A.J. van Rossum, M. van Veenendaal,
T.W. Kuijpers, M. Maas
Academisch Medisch Centrum, Amsterdam
Purpose: MRI is the most preferred imaging modality in
detecting joint pathologies in Juvenile Idiopathic Arthritis
(JIA), despite practical limitations. Gadolinium (Gd) contrast
use prolongs examination time, increases invasiveness and
patient discomfort, and thereby reduces feasibility of MRI
in JIA patients. Therefore, our objective is to evaluate if JIA
joint pathologies can be reliably assessed by MRI
without Gd injection compared with Gd-enhanced MRI as
the reference.
Methods: Data-sets (open-bore, 1.0T) of 46 JIA patients
(mean age 12 years [range 4-18]) were prospectively scored
twice by two experienced readers for the presence of knee
joint pathologies. MRI features were evaluated using a
literature-based assessment score, comprising synovial
hypertrophy, bone marrow edema (BME), cartilage lesions
and bone erosions. The first reading included unenhanced
images (-Gd), whereas complete image sets were available
for the second reading (+Gd).
Results: Using +Gd MRI as the reference, sensitivity and
specificity of -Gd MRI in the detection of BME (89%, 99%),
cartilage lesions (73%, 100%) and erosions (100%, 99%)
were high. Good -Gd and +Gd interreader agreements (ICC)
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