David Bruining, M. D., discusses a recent study published in the American Journal of Gastroenterology about diffusion-weighted magnetic resonance imaging in inflammatory bowel disease. Diffusion-weighted imaging (DWI) is a new method of assessing the small bowel in patients with Crohn's disease.
What's unique about this study is researchers from France looked at 130 patients with Crohn's disease. The researchers performed routine MRIs but also looked at additional images with DWI. This type of imaging looks at the properties of water molecule transfer. In inflamed tissue, this transfer could be impaired and the abnormal segments in the small bowel could be identified. In the 130 patients with Crohn's disease, standard MRI images scores were compared with DWI scores. The results showed a good correlation between the two scores.
The use of DWI could eliminate the need for IV contrast, specifically the use of gadolinium. This could become a good option for patients that cannot have IV contrast. The use of gadolinium is avoided during the first trimester of pregnancy and in patients with renal insufficiency. There are some questions about the specificity of DWI images but it is an exciting option to use for patients that cannot be exposed to IV contests. Mayo Clinic does use DWI images but still provides IV contrast in most cases.
The full article may be read here.
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Dr. Bruining is a gastroenterologist at Mayo Clinic.