Viscoelastic properties of small bowel mesentery at MR elastography in Crohn's disease: a prospective cross-sectional exploratory study.
Crohn’s disease
Elasticity imaging techniques
Magnetic resonance elastography
Magnetic resonance imaging
Mesentery
Journal
European radiology experimental
ISSN: 2509-9280
Titre abrégé: Eur Radiol Exp
Pays: England
ID NLM: 101721752
Informations de publication
Date de publication:
18 09 2023
18 09 2023
Historique:
received:
13
04
2023
accepted:
22
06
2023
medline:
19
9
2023
pubmed:
18
9
2023
entrez:
17
9
2023
Statut:
epublish
Résumé
Creeping fat is a pathological feature of small bowel Crohn's disease (CD), with literature suggesting that bowel resection with extended mesenteric resection is related to less postoperative recurrences. Conventional imaging is unable to accurately quantify the disease involvement (i.e., fibrosis) of creeping fat. Quantification of disease involvement could be useful in decision-making for additional extended mesenteric resection. We investigated the feasibility of magnetic resonance elastography (MRE) of the mesentery and if MRE is capable to detect fibrotic disease involvement of mesentery in active CD. Multifrequency MRE yielded spatial stiffness (shear wave speed, SWS, |G*|) and fluidity maps (φ). Viscoelastic properties of seven CD patients' mesentery were compared to age- and sex-matched healthy volunteers (HV) (Mann-Whitney U-test). Within CD patients, the affected and "presumably" unaffected mesentery were compared (Wilcoxon-signed rank test). Repeatability was tested in 15 HVs (Bland-Altman analysis, coefficient of variation [CoV]). Spearman rank correlations were used to investigate the relation between microscopically scored amount of mesenteric fibrosis and viscoelastic parameters. SWS, |G*|, and φ of affected mesentery in CD were higher compared to HV (p = 0.017, p = 0.001, p = 0.017). Strong correlations were found between percentage of area of mesenteric fibrosis and SWS and |G*| (p < 0.010). No differences were found within CD between affected and presumably unaffected mesentery. Repeatability of SWS showed 95% limits of agreement of (-0.09, 0.13 m/s) and within-subject CoV of 5.3%. MRE may have the potential to measure fibrotic disease involvement of the mesentery in CD, possibly guiding clinical decision-making with respect to extended mesenteric resection. Dutch trial register, NL9105 , registered 7 December 2020. MRE may have the potential to measure the amount of mesenteric fibrosis of the affected mesenteric fat in active Crohn's disease, giving more insight into disease progression and could potentially play a role in clinical decision-making for extended mesenteric resection. • MRE of the mesentery in patients with active CD is feasible. • Fluidity and stiffness of the mesentery increase in active CD, while stiffness correlates with the histopathological amount of mesenteric fibrosis. • MRE provides biomarkers to quantify mesenteric disease activity in active CD.
Sections du résumé
BACKGROUND
Creeping fat is a pathological feature of small bowel Crohn's disease (CD), with literature suggesting that bowel resection with extended mesenteric resection is related to less postoperative recurrences. Conventional imaging is unable to accurately quantify the disease involvement (i.e., fibrosis) of creeping fat. Quantification of disease involvement could be useful in decision-making for additional extended mesenteric resection. We investigated the feasibility of magnetic resonance elastography (MRE) of the mesentery and if MRE is capable to detect fibrotic disease involvement of mesentery in active CD.
METHODS
Multifrequency MRE yielded spatial stiffness (shear wave speed, SWS, |G*|) and fluidity maps (φ). Viscoelastic properties of seven CD patients' mesentery were compared to age- and sex-matched healthy volunteers (HV) (Mann-Whitney U-test). Within CD patients, the affected and "presumably" unaffected mesentery were compared (Wilcoxon-signed rank test). Repeatability was tested in 15 HVs (Bland-Altman analysis, coefficient of variation [CoV]). Spearman rank correlations were used to investigate the relation between microscopically scored amount of mesenteric fibrosis and viscoelastic parameters.
RESULTS
SWS, |G*|, and φ of affected mesentery in CD were higher compared to HV (p = 0.017, p = 0.001, p = 0.017). Strong correlations were found between percentage of area of mesenteric fibrosis and SWS and |G*| (p < 0.010). No differences were found within CD between affected and presumably unaffected mesentery. Repeatability of SWS showed 95% limits of agreement of (-0.09, 0.13 m/s) and within-subject CoV of 5.3%.
CONCLUSION
MRE may have the potential to measure fibrotic disease involvement of the mesentery in CD, possibly guiding clinical decision-making with respect to extended mesenteric resection.
TRIAL REGISTRATION
Dutch trial register, NL9105 , registered 7 December 2020.
RELEVANCE STATEMENT
MRE may have the potential to measure the amount of mesenteric fibrosis of the affected mesenteric fat in active Crohn's disease, giving more insight into disease progression and could potentially play a role in clinical decision-making for extended mesenteric resection.
KEY POINTS
• MRE of the mesentery in patients with active CD is feasible. • Fluidity and stiffness of the mesentery increase in active CD, while stiffness correlates with the histopathological amount of mesenteric fibrosis. • MRE provides biomarkers to quantify mesenteric disease activity in active CD.
Identifiants
pubmed: 37718360
doi: 10.1186/s41747-023-00366-5
pii: 10.1186/s41747-023-00366-5
pmc: PMC10505604
doi:
Banques de données
NTR
['NL9105']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
53Informations de copyright
© 2023. European Society of Radiology (ESR).
Références
Colorectal Dis. 2015 Mar;17(3):225-34
pubmed: 25307174
J Crohns Colitis. 2017 Feb;11(2):135-149
pubmed: 27660342
J Magn Reson Imaging. 2019 Dec;50(6):1982-1989
pubmed: 31087619
Clin Gastroenterol Hepatol. 2011 Aug;9(8):684-687.e1
pubmed: 21642015
Dig Surg. 2014;31(3):219-24
pubmed: 25277149
Clin Radiol. 2016 Oct;71(10):1068.e7-1068.e12
pubmed: 27132114
BJS Open. 2022 Jan 06;6(1):
pubmed: 35171266
J Magn Reson Imaging. 2012 Oct;36(4):757-74
pubmed: 22987755
Gut. 2006 Jun;55(6):749-53
pubmed: 16698746
J Pathol. 2000 Feb;190(2):196-202
pubmed: 10657019
Inflamm Bowel Dis. 2022 May 4;28(5):657-666
pubmed: 34291800
World J Radiol. 2016 Jan 28;8(1):59-72
pubmed: 26834944
J Crohns Colitis. 2021 Jul 5;15(7):1161-1173
pubmed: 33411893
Gut. 2022 Jul;71(7):1289-1301
pubmed: 34261752
Ann Surg. 2020 Aug;272(2):210-217
pubmed: 32675483
Biomed Res Int. 2017;2017:4257987
pubmed: 29214167
Br J Surg. 1992 Sep;79(9):955-8
pubmed: 1422768
Magn Reson Med. 2021 May;85(5):2377-2390
pubmed: 33296103
Clin Transl Gastroenterol. 2021 Oct 1;12(10):e00407
pubmed: 34597277
Aliment Pharmacol Ther. 2018 Dec;48(11-12):1232-1241
pubmed: 30345577
AJR Am J Roentgenol. 2015 Jul;205(1):33-40
pubmed: 25905762
Inflamm Bowel Dis. 2015 Nov;21(11):2590-7
pubmed: 26222339
Med Image Anal. 2016 May;30:1-10
pubmed: 26845371
Therap Adv Gastroenterol. 2022 Sep 6;15:17562848221122504
pubmed: 36090482
Inflamm Bowel Dis. 2019 Feb 21;25(3):421-426
pubmed: 30346528
Phys Med Biol. 2009 Apr 7;54(7):2229-41
pubmed: 19293467
J Mech Behav Biomed Mater. 2021 Sep;121:104645
pubmed: 34166871
Inflamm Bowel Dis. 2015 Feb;21(2):453-67
pubmed: 25248003
J Crohns Colitis. 2018 Nov 09;12(10):1139-1150
pubmed: 29309546
Cancer Res. 2019 Nov 15;79(22):5704-5710
pubmed: 31551364
Proc Natl Acad Sci U S A. 2020 Jan 7;117(1):128-134
pubmed: 31843897
J Magn Reson Imaging. 2015 Feb;41(2):369-75
pubmed: 24497052
Cell. 2020 Oct 29;183(3):666-683.e17
pubmed: 32991841