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20. Rimola J, Ordás I, Rodriguez S, García-Bosch O, Aceituno M, Llach J, et al. Magnetic resonance imaging for evaluation of Crohn's disease: validation of parameters of severity and quantitative index of activity. Inflamm Bowel Dis. août 2011;17(8):1759-68.

21. Ordás I, Rimola J, Alfaro I, Rodríguez S, Castro-Poceiro J, Ramírez-Morros A, et al. Development and Validation of a Simplified Magnetic Resonance Index of Activity for Crohn's Disease. Gastroenterology. août 2019;157(2):432-439.e1.

22. Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. juin 2006;55(6):749-53.
12. Calabrese E, Maaser C, Zorzi F, Kannengiesser K, Hanauer SB, Bruining DH, et al. Bowel Ultrasonography in the Management of Crohn's Disease. A Review with Recommendations of an International Panel of Experts. Inflamm Bowel Dis. mai 2016;22(5):1168-83.

13. Maaser C, Sturm A, Vavricka SR, Kucharzik T, Fiorino G, Annese V, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis. 1 févr 2019;13(2):144-64.

14. Paulsen SR, Huprich JE, Fletcher JG, Booya F, Young BM, Fidler JL, et al. CT enterography as a diagnostic tool in evaluating small bowel disorders: review of clinical experience with over 700 cases. Radiographics. 2006;26(3):641-57; discussion 657-662.

15. Bodily KD, Fletcher JG, Solem CA, Johnson CD, Fidler JL, Barlow JM, et al. Crohn Disease: mural attenuation and thickness at contrast-enhanced CT Enterography--correlation with endoscopic and histologic findings of inflammation. Radiology. févr 2006;238(2):505-16.

16. Estay C, Simian D, Lubascher J, Figueroa C, O'Brien A, Quera R. Ionizing radiation exposure in patients with inflammatory bowel disease: are we overexposing our patients? J Dig Dis. févr 2015;16(2):83-9.

17. Buisson A, Pereira B, Goutte M, Reymond M, Allimant C, Obritin-Guilhen H, et al. Magnetic resonance index of activity (MaRIA) and Clermont score are highly and equally effective MRI indices in detecting mucosal healing in Crohn's disease. Dig Liver Dis. nov 2017;49(11):1211-7.

18. Buisson A, Gonzalez F, Poullenot F, Nancey S, Sollellis E, Fumery M, et al. Comparative Acceptability and Perceived Clinical Utility of Monitoring Tools: A Nationwide Survey of Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis. août 2017;23(8):1425-33.

19. Rimola J, Rodriguez S, García-Bosch O, Ordás I, Ayala E, Aceituno M, et al. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn's disease. Gut. août 2009;58(8):1113-20.

20. Rimola J, Ordás I, Rodriguez S, García-Bosch O, Aceituno M, Llach J, et al. Magnetic resonance imaging for evaluation of Crohn's disease: validation of parameters of severity and quantitative index of activity. Inflamm Bowel Dis. août 2011;17(8):1759-68.

21. Ordás I, Rimola J, Alfaro I, Rodríguez S, Castro-Poceiro J, Ramírez-Morros A, et al. Development and Validation of a Simplified Magnetic Resonance Index of Activity for Crohn's Disease. Gastroenterology. août 2019;157(2):432-439.e1.

22. Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. juin 2006;55(6):749-53.
23. Ajaj W, Goehde SC, Schneemann H, Ruehm SG, Debatin JF, Lauenstein TC. Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension. Eur Radiol. mars 2004;14(3):458-64.

24. Quattrocchi CC, van der Molen AJ. Gadolinium Retention in the Body and Brain: Is It Time for an International Joint Research Effort? Radiology. janv 2017;282(1):12-6.

25. Beam AS, Moore KG, Gillis SN, Ford KF, Gray T, Steinwinder AH, et al. GBCAs and Risk for Nephrogenic Systemic Fibrosis: A Literature Review. Radiol Technol. juill 2017;88(6):583-9.

26. Kastler B, Vetter D. Comprendre l'IRM - Manuel d'auto-apprentissage. 8e éd. Elsevier Masson; 2018. 424 p.

27. Choi SH, Kim KW, Lee JY, Kim KJ, Park SH. Diffusion-weighted Magnetic Resonance Enterography for Evaluating Bowel Inflammation in Crohn's Disease: A Systematic Review and Meta-analysis. Inflamm Bowel Dis. mars 2016;22(3):669-79.

28. Dohan A, Taylor S, Hoeffel C, Barret M, Allez M, Dautry R, et al. Diffusion-weighted MRI in Crohn's disease: Current status and recommendations. J Magn Reson Imaging. déc 2016;44(6):1381-96.

29. Pouillon L, Laurent V, Pouillon M, Bossuyt P, Bonifacio C, Danese S, et al. Diffusion-weighted MRI in inflammatory bowel disease. Lancet Gastroenterol Hepatol. juin 2018;3(6):433-43.

30. Oussalah A, Laurent V, Bruot O, Bressenot A, Bigard MA, Régent D, et al. Diffusion-weighted magnetic resonance without bowel preparation for detecting colonic inflammation in inflammatory bowel disease. Gut. août 2010;59(8):1056-65.

31. Buisson A, Joubert A, Montoriol PF, Da Ines D, Hordonneau C, Pereira B, et al. Diffusion-weighted magnetic resonance imaging for detecting and assessing ileal inflammation in Crohn's disease. Aliment Pharmacol Ther. mars 2013;37(5):537-45.

32. Hordonneau C, Buisson A, Scanzi J, Goutorbe F, Pereira B, Borderon C, et al. Diffusion-weighted magnetic resonance imaging in ileocolonic Crohn's disease: validation of quantitative index of activity. Am J Gastroenterol. janv 2014;109(1):89-98.

33. Yu LL, Yang HS, Zhang BT, Lv ZW, Wang FR, Zhang CY, et al. Diffusion-weighted magnetic resonance imaging without bowel preparation for detection of ulcerative colitis. World J Gastroenterol. 7 sept 2015;21(33):9785-92.

34. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. mars 1977;33(1):159-74.
23. Ajaj W, Goehde SC, Schneemann H, Ruehm SG, Debatin JF, Lauenstein TC. Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension. Eur Radiol. mars 2004;14(3):458-64.

24. Quattrocchi CC, van der Molen AJ. Gadolinium Retention in the Body and Brain: Is It Time for an International Joint Research Effort? Radiology. janv 2017;282(1):12-6.

25. Beam AS, Moore KG, Gillis SN, Ford KF, Gray T, Steinwinder AH, et al. GBCAs and Risk for Nephrogenic Systemic Fibrosis: A Literature Review. Radiol Technol. juill 2017;88(6):583-9.

26. Kastler B, Vetter D. Comprendre l'IRM - Manuel d'auto-apprentissage. 8e éd. Elsevier Masson; 2018. 424 p.

27. Choi SH, Kim KW, Lee JY, Kim KJ, Park SH. Diffusion-weighted Magnetic Resonance Enterography for Evaluating Bowel Inflammation in Crohn's Disease: A Systematic Review and Meta-analysis. Inflamm Bowel Dis. mars 2016;22(3):669-79.

28. Dohan A, Taylor S, Hoeffel C, Barret M, Allez M, Dautry R, et al. Diffusion-weighted MRI in Crohn's disease: Current status and recommendations. J Magn Reson Imaging. déc 2016;44(6):1381-96.

29. Pouillon L, Laurent V, Pouillon M, Bossuyt P, Bonifacio C, Danese S, et al. Diffusion-weighted MRI in inflammatory bowel disease. Lancet Gastroenterol Hepatol. juin 2018;3(6):433-43.

30. Oussalah A, Laurent V, Bruot O, Bressenot A, Bigard MA, Régent D, et al. Diffusion-weighted magnetic resonance without bowel preparation for detecting colonic inflammation in inflammatory bowel disease. Gut. août 2010;59(8):1056-65.

31. Buisson A, Joubert A, Montoriol PF, Da Ines D, Hordonneau C, Pereira B, et al. Diffusion-weighted magnetic resonance imaging for detecting and assessing ileal inflammation in Crohn's disease. Aliment Pharmacol Ther. mars 2013;37(5):537-45.

32. Hordonneau C, Buisson A, Scanzi J, Goutorbe F, Pereira B, Borderon C, et al. Diffusion-weighted magnetic resonance imaging in ileocolonic Crohn's disease: validation of quantitative index of activity. Am J Gastroenterol. janv 2014;109(1):89-98.

33. Yu LL, Yang HS, Zhang BT, Lv ZW, Wang FR, Zhang CY, et al. Diffusion-weighted magnetic resonance imaging without bowel preparation for detection of ulcerative colitis. World J Gastroenterol. 7 sept 2015;21(33):9785-92.

34. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. mars 1977;33(1):159-74.
35. Stöss C, Berlet M, Reischl S, Nitsche U, Weber MC, Friess H, et al. Crohn's disease: a population-based study of surgery in the age of biological therapy. Int J Colorectal Dis. nov 2021;36(11):2419-26.

36. Arnott IDR, Watts D, Ghosh S. Review article: is clinical remission the optimum therapeutic goal in the treatment of Crohn's disease? Aliment Pharmacol Ther. mai 2002;16(5):857-67.

37. Tielbeek JAW, Ziech MLW, Li Z, Lavini C, Bipat S, Bemelman WA, et al. Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn's disease assessment with histopathology of surgical specimens. Eur Radiol. mars 2014;24(3):619-29.

38. Kim KJ, Lee Y, Park SH, Kang BK, Seo N, Yang SK, et al. Diffusion-weighted MR enterography for evaluating Crohn's disease: how does it add diagnostically to conventional MR enterography? Inflamm Bowel Dis. janv 2015;21(1):101-9.

39. Li XH, Sun CH, Mao R, Zhang ZW, Jiang XS, Pui MH, et al. Assessment of Activity of Crohn Disease by Diffusion-Weighted Magnetic Resonance Imaging. Medicine (Baltimore). oct 2015;94(43):e1819.

40. Qi F, Jun S, Qi QY, Chen PJ, Chuan GX, Jiong Z, et al. Utility of the diffusion-weighted imaging for activity evaluation in Crohn's disease patients underwent magnetic resonance enterography. BMC Gastroenterol. 5 févr 2015;15:12.

41. Seo N, Park SH, Kim KJ, Kang BK, Lee Y, Yang SK, et al. MR Enterography for the Evaluation of Small-Bowel Inflammation in Crohn Disease by Using Diffusion-weighted Imaging without Intravenous Contrast Material: A Prospective Noninferiority Study. Radiology. mars 2016;278(3):762-72.

42. Pendsé DA, Makanyanga JC, Plumb AA, Bhatnagar G, Atkinson D, Rodriguez-Justo M, et al. Diffusion-weighted imaging for evaluating inflammatory activity in Crohn's disease: comparison with histopathology, conventional MRI activity scores, and faecal calprotectin. Abdom Radiol (NY). janv 2017;42(1):115-23.

43. Feng Q, Yan YQ, Zhu J, Tong JL, Xu JR. Optimal b value of diffusion-weighted imaging on a 3.0T magnetic resonance scanner in Crohn's disease. World J Gastroenterol. 21 sept 2014;20(35):12621-7.

44. Soydan L, Demir AA, Ozer S, Ozkara S. Can MR Enterography and Diffusion-Weighted Imaging Predict Disease Activity Assessed by Simple Endoscopic Score for Crohn's Disease? J Belg Soc Radiol. 18 janv 2019;103(1):10.
35. Stöss C, Berlet M, Reischl S, Nitsche U, Weber MC, Friess H, et al. Crohn's disease: a population-based study of surgery in the age of biological therapy. Int J Colorectal Dis. nov 2021;36(11):2419-26.

36. Arnott IDR, Watts D, Ghosh S. Review article: is clinical remission the optimum therapeutic goal in the treatment of Crohn's disease? Aliment Pharmacol Ther. mai 2002;16(5):857-67.

37. Tielbeek JAW, Ziech MLW, Li Z, Lavini C, Bipat S, Bemelman WA, et al. Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn's disease assessment with histopathology of surgical specimens. Eur Radiol. mars 2014;24(3):619-29.

38. Kim KJ, Lee Y, Park SH, Kang BK, Seo N, Yang SK, et al. Diffusion-weighted MR enterography for evaluating Crohn's disease: how does it add diagnostically to conventional MR enterography? Inflamm Bowel Dis. janv 2015;21(1):101-9.

39. Li XH, Sun CH, Mao R, Zhang ZW, Jiang XS, Pui MH, et al. Assessment of Activity of Crohn Disease by Diffusion-Weighted Magnetic Resonance Imaging. Medicine (Baltimore). oct 2015;94(43):e1819.

40. Qi F, Jun S, Qi QY, Chen PJ, Chuan GX, Jiong Z, et al. Utility of the diffusion-weighted imaging for activity evaluation in Crohn's disease patients underwent magnetic resonance enterography. BMC Gastroenterol. 5 févr 2015;15:12.

41. Seo N, Park SH, Kim KJ, Kang BK, Lee Y, Yang SK, et al. MR Enterography for the Evaluation of Small-Bowel Inflammation in Crohn Disease by Using Diffusion-weighted Imaging without Intravenous Contrast Material: A Prospective Noninferiority Study. Radiology. mars 2016;278(3):762-72.

42. Pendsé DA, Makanyanga JC, Plumb AA, Bhatnagar G, Atkinson D, Rodriguez-Justo M, et al. Diffusion-weighted imaging for evaluating inflammatory activity in Crohn's disease: comparison with histopathology, conventional MRI activity scores, and faecal calprotectin. Abdom Radiol (NY). janv 2017;42(1):115-23.

43. Feng Q, Yan YQ, Zhu J, Tong JL, Xu JR. Optimal b value of diffusion-weighted imaging on a 3.0T magnetic resonance scanner in Crohn's disease. World J Gastroenterol. 21 sept 2014;20(35):12621-7.

44. Soydan L, Demir AA, Ozer S, Ozkara S. Can MR Enterography and Diffusion-Weighted Imaging Predict Disease Activity Assessed by Simple Endoscopic Score for Crohn's Disease? J Belg Soc Radiol. 18 janv 2019;103(1):10.
45. Rieder F, Latella G, Magro F, Yuksel ES, Higgins PDR, Di Sabatino A, et al. European Crohn's and Colitis Organisation Topical Review on Prediction, Diagnosis and Management of Fibrostenosing Crohn's Disease. J Crohns Colitis. août 2016;10(8):873-85.

46. Rimola J, Planell N, Rodríguez S, Delgado S, Ordás I, Ramírez-Morros A, et al. Characterization of inflammation and fibrosis in Crohn's disease lesions by magnetic resonance imaging. Am J Gastroenterol. mars 2015;110(3):432-40.

47. Li XH, Mao R, Huang SY, Fang ZN, Lu BL, Lin JJ, et al. Ability of DWI to characterize bowel fibrosis depends on the degree of bowel inflammation. Eur Radiol. mai 2019;29(5):2465-73.

48. Caruso A, Angriman I, Scarpa M, D'Incà R, Mescoli C, Rudatis M, et al. Diffusion-weighted magnetic resonance for assessing fibrosis in Crohn's disease. Abdom Radiol (NY). août 2020;45(8):2327-35.

49. Foti PV, Travali M, Farina R, Palmucci S, Coronella M, Spatola C, et al. Can Conventional and Diffusion-Weighted MR Enterography Biomarkers Differentiate Inflammatory from Fibrotic Strictures in Crohn's Disease? Medicina (Kaunas). 15 mars 2021;57(3):265.

50. Coimbra A, Rimola J, Cuatrecasas M, De Hertogh G, Van Assche G, Vanslembrouck R, et al. Magnetic Resonance Enterography and Histology in Patients With Fibrostenotic Crohn's Disease: A Multicenter Study. Clin Transl Gastroenterol. 1 juill 2022;13(7):e00505.

51. Wagner M, Ko HM, Chatterji M, Besa C, Torres J, Zhang X, et al. Magnetic Resonance Imaging Predicts Histopathological Composition of Ileal Crohn's Disease. J Crohns Colitis. 25 mai 2018;12(6):718-29.

52. Oto A, Kayhan A, Williams JTB, Fan X, Yun L, Arkani S, et al. Active Crohn's disease in the small bowel: evaluation by diffusion weighted imaging and quantitative dynamic contrast enhanced MR imaging. J Magn Reson Imaging. mars 2011;33(3):615-24.

53. Kiryu S, Dodanuki K, Takao H, Watanabe M, Inoue Y, Takazoe M, et al. Free-breathing diffusion-weighted imaging for the assessment of inflammatory activity in Crohn's disease. J Magn Reson Imaging. avr 2009;29(4):880-6.
45. Rieder F, Latella G, Magro F, Yuksel ES, Higgins PDR, Di Sabatino A, et al. European Crohn's and Colitis Organisation Topical Review on Prediction, Diagnosis and Management of Fibrostenosing Crohn's Disease. J Crohns Colitis. août 2016;10(8):873-85.

46. Rimola J, Planell N, Rodríguez S, Delgado S, Ordás I, Ramírez-Morros A, et al. Characterization of inflammation and fibrosis in Crohn's disease lesions by magnetic resonance imaging. Am J Gastroenterol. mars 2015;110(3):432-40.

47. Li XH, Mao R, Huang SY, Fang ZN, Lu BL, Lin JJ, et al. Ability of DWI to characterize bowel fibrosis depends on the degree of bowel inflammation. Eur Radiol. mai 2019;29(5):2465-73.

48. Caruso A, Angriman I, Scarpa M, D'Incà R, Mescoli C, Rudatis M, et al. Diffusion-weighted magnetic resonance for assessing fibrosis in Crohn's disease. Abdom Radiol (NY). août 2020;45(8):2327-35.

49. Foti PV, Travali M, Farina R, Palmucci S, Coronella M, Spatola C, et al. Can Conventional and Diffusion-Weighted MR Enterography Biomarkers Differentiate Inflammatory from Fibrotic Strictures in Crohn's Disease? Medicina (Kaunas). 15 mars 2021;57(3):265.

50. Coimbra A, Rimola J, Cuatrecasas M, De Hertogh G, Van Assche G, Vanslembrouck R, et al. Magnetic Resonance Enterography and Histology in Patients With Fibrostenotic Crohn's Disease: A Multicenter Study. Clin Transl Gastroenterol. 1 juill 2022;13(7):e00505.

51. Wagner M, Ko HM, Chatterji M, Besa C, Torres J, Zhang X, et al. Magnetic Resonance Imaging Predicts Histopathological Composition of Ileal Crohn's Disease. J Crohns Colitis. 25 mai 2018;12(6):718-29.

52. Oto A, Kayhan A, Williams JTB, Fan X, Yun L, Arkani S, et al. Active Crohn's disease in the small bowel: evaluation by diffusion weighted imaging and quantitative dynamic contrast enhanced MR imaging. J Magn Reson Imaging. mars 2011;33(3):615-24.

53. Kiryu S, Dodanuki K, Takao H, Watanabe M, Inoue Y, Takazoe M, et al. Free-breathing diffusion-weighted imaging for the assessment of inflammatory activity in Crohn's disease. J Magn Reson Imaging. avr 2009;29(4):880-6.
## Évaluation de l'entéro-IRM de diffusion à 3T, sans et avec balisage intestinal, dans le suivi de patients atteints de la maladie de Crohn

**Introduction** : L'entéro-IRM occupe une place importante dans le suivi des patients atteints de la maladie de Crohn. L'imagerie de diffusion pourrait être une alternative à l'injection de gadolinium dans l'évaluation de la réponse au traitement. L'objectif de cette étude est d'étudier ses performances diagnostiques à 3T, sans et avec balisage intestinal, dans la détection des atteintes du grêle et l'évaluation de leur activité inflammatoire comparativement à l'entéro-IRM injectée.

**Méthode** : Tout patient âgé de plus de 18 ans devant bénéficier d'une entéro-IRM dans le cadre de son suivi de maladie de Crohn avec atteinte du grêle était éligible à une inclusion. Deux IRM, sans et avec balisage intestinal, ont été réalisées puis relues en aveugle des données du patient.

**Résultats** : 35 patients ont été inclus de manière prospective. L'imagerie de diffusion avec balisage intestinal présentait une sensibilité de 84 à 88% et une spécificité de 50 à 90% pour la détection des atteintes et un accord modéré avec l'entéro-IRM conventionnelle pour la détection de l'activité.

**Conclusion** : L'imagerie de diffusion à 3T semble prometteuse dans la détection des atteintes du grêle et l'évaluation de leur activité inflammatoire dans le suivi des patients atteints de la maladie de Crohn. Des études sur un plus grand nombre de patients pourraient permettre d'évaluer avec plus de précision l'impact du balisage intestinal sur ses performances diagnostiques dans cette indication.

**Mots-clés** : maladie de Crohn, grêle, diffusion, inflammation, balisage intestinal

## Evaluation of 3T diffusion entero-MRI, without and with bowel preparation, in the follow-up of patients with Crohn's disease

**Introduction** : Entero-MRI plays an important role in the follow-up of patients with Crohn's disease. Diffusion imaging could be an alternative to gadolinium injection in assessing response to treatment. The aim of this study is to investigate its diagnostic performance at 3T, without and with bowel preparation, in detecting small bowel involvement and its inflammatory activity compared with injected entero-MRI.

**Method** : Any patient over 18 years of age requiring entero-MRI as part of the follow-up for Crohn's disease with small bowel involvement was eligible for inclusion. Two MRI, without and with bowel preparation, were performed and then reread blinded to the patient's data.

**Results** : 35 patients were prospectively included. Diffusion imaging with bowel preparation had a sensitivity of 84-88% and a specificity of 50-90% for the detection of involvement, and moderate agreement with conventional entero-MRI for the detection of activity.

**Conclusion** : Diffusion imaging at 3T appears promising for detecting small bowel involvement and assessing its inflammatory activity in the follow-up of patients with Crohn's disease. Studies on a larger number of patients could provide a more accurate assessment of the impact of bowel preparation on its diagnostic performance in this indication.

**Key words** : Crohn disease, bowel, diffusion, inflammation, bowel preparation
## Évaluation de l'entéro-IRM de diffusion à 3T, sans et avec balisage intestinal, dans le suivi de patients atteints de la maladie de Crohn

**Introduction** : L'entéro-IRM occupe une place importante dans le suivi des patients atteints de la maladie de Crohn. L'imagerie de diffusion pourrait être une alternative à l'injection de gadolinium dans l'évaluation de la réponse au traitement. L'objectif de cette étude est d'étudier ses performances diagnostiques à 3T, sans et avec balisage intestinal, dans la détection des atteintes du grêle et l'évaluation de leur activité inflammatoire comparativement à l'entéro-IRM injectée.

**Méthode** : Tout patient âgé de plus de 18 ans devant bénéficier d'une entéro-IRM dans le cadre de son suivi de maladie de Crohn avec atteinte du grêle était éligible à une inclusion. Deux IRM, sans et avec balisage intestinal, ont été réalisées puis relues en aveugle des données du patient.

**Résultats** : 35 patients ont été inclus de manière prospective. L'imagerie de diffusion avec balisage intestinal présentait une sensibilité de 84 à 88% et une spécificité de 50 à 90% pour la détection des atteintes et un accord modéré avec l'entéro-IRM conventionnelle pour la détection de l'activité.

**Conclusion** : L'imagerie de diffusion à 3T semble prometteuse dans la détection des atteintes du grêle et l'évaluation de leur activité inflammatoire dans le suivi des patients atteints de la maladie de Crohn. Des études sur un plus grand nombre de patients pourraient permettre d'évaluer avec plus de précision l'impact du balisage intestinal sur ses performances diagnostiques dans cette indication.

**Mots-clés** : maladie de Crohn, grêle, diffusion, inflammation, balisage intestinal

## Evaluation of 3T diffusion entero-MRI, without and with bowel preparation, in the follow-up of patients with Crohn's disease

**Introduction** : Entero-MRI plays an important role in the follow-up of patients with Crohn's disease. Diffusion imaging could be an alternative to gadolinium injection in assessing response to treatment. The aim of this study is to investigate its diagnostic performance at 3T, without and with bowel preparation, in detecting small bowel involvement and its inflammatory activity compared with injected entero-MRI.

**Method** : Any patient over 18 years of age requiring entero-MRI as part of the follow-up for Crohn's disease with small bowel involvement was eligible for inclusion. Two MRI, without and with bowel preparation, were performed and then reread blinded to the patient's data.

**Results** : 35 patients were prospectively included. Diffusion imaging with bowel preparation had a sensitivity of 84-88% and a specificity of 50-90% for the detection of involvement, and moderate agreement with conventional entero-MRI for the detection of activity.

**Conclusion** : Diffusion imaging at 3T appears promising for detecting small bowel involvement and assessing its inflammatory activity in the follow-up of patients with Crohn's disease. Studies on a larger number of patients could provide a more accurate assessment of the impact of bowel preparation on its diagnostic performance in this indication.

**Key words** : Crohn disease, bowel, diffusion, inflammation, bowel preparation