Original Research — Gastrointestinal Imaging
Diffusion-weighted MRI: Role in detecting abdominopelvic internal fistulas and sinus tracts
Article first published online: 23 SEP 2011
Copyright © 2011 Wiley Periodicals, Inc.
Journal of Magnetic Resonance Imaging
Volume 35, Issue 1, pages 125–131, January 2012
How to Cite
Schmid-Tannwald, C., Agrawal, G., Dahi, F., Sethi, I. and Oto, A. (2012), Diffusion-weighted MRI: Role in detecting abdominopelvic internal fistulas and sinus tracts. J. Magn. Reson. Imaging, 35: 125–131. doi: 10.1002/jmri.22804
- Issue published online: 15 DEC 2011
- Article first published online: 23 SEP 2011
- Manuscript Accepted: 11 AUG 2011
- Manuscript Received: 18 JAN 2011
- magnetic resonance imaging;
- diffusion-weighted imaging;
- abdominopelvic internal fistulas and sinus tracts
To retrospectively determine the incremental value of diffusion-weighted MR-imaging (DW-MRI) to T2-weighted (T2w) images in diagnosis of internal fistulas (IFs) and sinus tracts (STs).
Materials and Methods:
Fourteen patients with 25 IFs and STs arising from the small bowel (20), colon (4) and biliary tract (1) were included. Two independent observers reviewed T2w images, T2w+DW-MRI images and T2w+contrast enhanced T1-weighted (CE T1w) images at three sessions to detect IF/ST based on a confidence scale of five. Sensitivity and confidence score of each session was compared.
10/25 (40%) and 9/25 (36%) IFs and STs were detected on T2w images by observer 1 and 2, respectively. Both observers detected 19/25 (76%) and 24/25(96%) IFs and STs on T2w+DW-MRI and T2w+CE T1w images, respectively. Detection rate and confidence score improved significantly by combining T2w images with DW-MRI or CE T1w images (reader 1 + 2: P ≤ 0.01). There was no significant difference between the IF/ST detection rate of T2w+DW-MRI and T2w+CE T1 image combinations. Confidence scores with T2w+CE T1w images were significantly greater than DW-MRI+T2w images (reader 1:P = 0.01; reader 2: P = 0.03).
DW-MRI showed additional value to T2w imaging for diagnosis of IF and ST. DW-MRI can be a useful adjunct, especially for patients with renal failure. J. Magn. Reson. Imaging 2012;35:125-131. © 2011 Wiley Periodicals, Inc.