Hi generally we do this with excellent results, can you be more specific about the problems you are having?

Tks for your answer.

We are using DWI in all MRI-enterography but we didn't find a good correlation between CDAI and DWi imaging. I think because the best correlation can be found with transmural signs of disease. Instead it is really useful in improving the visualization of extension of disease.

Hi really sorry totally forgot about this.

Largely I agree with you - not sure it adds hugely to the other sequences. However we have found it correlates pretty well with other measures of activity e.g. calprotectin, histology and overall MRI score.

Generally we rely on subjective impression of the DWI rather than measuring ADC - which can be challenging if the bowel wall is not very thick e.g. mild disease. Also the bowel often moves a bit between acquiring the different b value images so can be hard to get a nice accurate ADC.

We do it as part of our overall protocol which includes T2 / T2-FS / DCE / DWI / motility. I suspect we could drop the contrast and just rely on the T2 / diffusion / motility and get the answer right 99% of the time.

Certainly we have had several cases with relatively subtle surface disease (especially in younger / adolescent patients) where the T2 is almost completely normal but the DWI is very abnormal and alerted us to the fact they had diffuse mucosal disease.

Tks for your answer,

at this moment I'm in vacancy but when I'll restart at work I'll send you some images of my protocol. I agree with you for the presence of motion artifacts (we use double dose of Buscopan). Now i'm trying to use DWI in pediatric patients without infusion of CM.

Hear you soon.

Giuseppe