Purpose: To prospectively determine mural perfusion dynamics in patients with untreated celiac disease by using dynamic contrast material-enhanced magnetic resonance (MR) imaging and to compare these dynamics with those in a control population and in patients with celiac disease treated with a gluten-free diet. Materials and Methods: Institutional review board approval and informed consent from all participants were obtained. Sixty consecutive patients with untreated celiac disease, 45 patients with celiac disease treated with a gluten-free diet for at least 1 year, and 30 control subjects were enrolled in this study. Dynamic contrast-enhanced MR imaging was performed by using a 1.5-T MR unit. For each MR imaging examination, maximum enhancement, slope of enhancement, and time-signal intensity curves were calculated at the level of the descending duodenal wall. Duodenal wall thickness was also evaluated. Statistical evaluation was performed by using one-way analysis of variance, and the results were confirmed by using the Bartlett test for equal variances and complemented by using Bonferroni multiple comparison, linear correlation, and the Student t test for paired data. Results: Mean maximum enhancement of the duodenal wall was significantly higher in patients with untreated celiac disease (229.1 +/- 46.4 [standard deviation]) than in patients with treated celiac disease (109.8 +/- 27.8) and control subjects (94.7 +/- 17.9) (P < .001 for each comparison). All 60 untreated patients showed a curve characterized by fast enhancement and washout (type 4), while all 45 treated patients and the 30 control subjects showed a curve characterized by slow constant enhancement (type 2). Mean duodenal wall thickness was not significantly different between untreated patients (2.2 mm +/- 0.4), treated patients (2.0 mm +/- 0.3), and control subjects (2.0 mm +/- 0.4) (one-way analysis of variance, P = .4177; Bartlett test, P = .6951). Conclusion: The results of this study suggest that dynamic evaluation of the bowel wall by using contrast-enhanced MR imaging can be an effective and reproducible way to show the inflammation state in celiac disease.

Celiac disease. Evaluation with dynamic contrast-enhanced MR imaging / Picarelli, Antonio; Di Tola, Marco; Libanori, V; Saponara, A; Masselli, Gabriele; Donato, Giuseppe; Polettini, Elisabetta; Piermattei, Maria Alessandra; Palumbo, Piergaspare; Pittalis, Angelo; Gualdi, Gianfranco. - In: RADIOLOGY. - ISSN 0033-8419. - 256:3(2010), pp. 783-790. [10.1148/radiol.10092160]

Celiac disease. Evaluation with dynamic contrast-enhanced MR imaging

PICARELLI, Antonio;DI TOLA, MARCO;MASSELLI, GABRIELE;DONATO, Giuseppe;POLETTINI, Elisabetta;PIERMATTEI, Maria Alessandra;PALUMBO, Piergaspare;PITTALIS, Angelo;GUALDI, GIANFRANCO
2010

Abstract

Purpose: To prospectively determine mural perfusion dynamics in patients with untreated celiac disease by using dynamic contrast material-enhanced magnetic resonance (MR) imaging and to compare these dynamics with those in a control population and in patients with celiac disease treated with a gluten-free diet. Materials and Methods: Institutional review board approval and informed consent from all participants were obtained. Sixty consecutive patients with untreated celiac disease, 45 patients with celiac disease treated with a gluten-free diet for at least 1 year, and 30 control subjects were enrolled in this study. Dynamic contrast-enhanced MR imaging was performed by using a 1.5-T MR unit. For each MR imaging examination, maximum enhancement, slope of enhancement, and time-signal intensity curves were calculated at the level of the descending duodenal wall. Duodenal wall thickness was also evaluated. Statistical evaluation was performed by using one-way analysis of variance, and the results were confirmed by using the Bartlett test for equal variances and complemented by using Bonferroni multiple comparison, linear correlation, and the Student t test for paired data. Results: Mean maximum enhancement of the duodenal wall was significantly higher in patients with untreated celiac disease (229.1 +/- 46.4 [standard deviation]) than in patients with treated celiac disease (109.8 +/- 27.8) and control subjects (94.7 +/- 17.9) (P < .001 for each comparison). All 60 untreated patients showed a curve characterized by fast enhancement and washout (type 4), while all 45 treated patients and the 30 control subjects showed a curve characterized by slow constant enhancement (type 2). Mean duodenal wall thickness was not significantly different between untreated patients (2.2 mm +/- 0.4), treated patients (2.0 mm +/- 0.3), and control subjects (2.0 mm +/- 0.4) (one-way analysis of variance, P = .4177; Bartlett test, P = .6951). Conclusion: The results of this study suggest that dynamic evaluation of the bowel wall by using contrast-enhanced MR imaging can be an effective and reproducible way to show the inflammation state in celiac disease.
celiac disease, magnetic resonance
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Celiac disease. Evaluation with dynamic contrast-enhanced MR imaging / Picarelli, Antonio; Di Tola, Marco; Libanori, V; Saponara, A; Masselli, Gabriele; Donato, Giuseppe; Polettini, Elisabetta; Piermattei, Maria Alessandra; Palumbo, Piergaspare; Pittalis, Angelo; Gualdi, Gianfranco. - In: RADIOLOGY. - ISSN 0033-8419. - 256:3(2010), pp. 783-790. [10.1148/radiol.10092160]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/225528
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