Native T1 Mapping and Magnetization Transfer Imaging in Grading Bowel Fibrosis in Crohn's Disease: A Comparative Animal Study

In this study, we investigated the utility of native T-1 mapping in differentiating between various grades of fibrosis and compared its diagnostic accuracy to magnetization transfer imaging (MTI) in a rat model of CD. Bowel specimens (64) from 46 CD model rats undergoing native T-1 mapping and MTI were enrolled. The longitudinal relaxation time (T-1 value) and normalized magnetization transfer ratio (MTR) were compared between none-to-mild and moderate-to-severe fibrotic bowel walls confirmed by pathological assessments. The results showed that the correlation between the T-1 value and fibrosis (r = 0.438, p < 0.001) was lower than that between the normalized MTR and fibrosis (r = 0.623, p < 0.001). Overall, the T-1 values (t = -3.066, p = 0.004) and normalized MTRs (z = 0.081, p < 0.001) in none-to-mild fibrotic bowel walls were lower than those in moderate-to-severe fibrotic bowel walls. The area under the curve (AUC) of the T-1 value (AUC = 0.716, p = 0.004) was significantly lower than that of the normalized MTR (AUC = 0.881, p < 0.001) in differentiating moderate-to-severe fibrosis from none-to-mild fibrosis (z = -2.037, p = 0.042). Our results support the view that the T-1 value could be a promising imaging biomarker in grading the fibrosis severity of CD. However, the diagnostic performance of native T-1 mapping was not superior to MTI.