Accuracy and interobserver agreement of diffusion-weighted imaging in pediatric inflammatory bowel disease.

PURPOSE: To determine interobserver agreement (IOA) and accuracy of conventional MR enterography (MRE), qualitative diffusion, and apparent diffusion coefficient (ADC) values for detecting clinically active inflammation.

METHODS: MREs in 57 consecutive children with suspected inflammatory bowel disease were retrospectively reviewed.

RESULTS: Substantial IOA for conventional MRE (kappa=0.65) and qualitative diffusion (kappa=0.64), but fair to good IOA for ADC, (intra-class coefficient=0.63) were seen. Conventional MRE detected active clinical inflammation well (area under curve [AUC] 0.725), while qualitative diffusion and ADC did not perform well (AUC=0.572 and 0.461, respectively).

CONCLUSION: DWI can be helpful in diagnosing inflammatory bowel disease but does not perform well in identifying those with active inflammation.