Objective: This study aims to evaluate the diagnostic utility of the T2-mapping sequence in patients with Crohn’s disease for detecting and quantifying intestinal wall edema, an indicator of active inflammation. Additionally, the study explores the correlation between T2-mapping measurements and fecal calprotectin levels, aiming to establish the potential relationship between imaging biomarkers and inflammatory laboratory markers.

Materials and Methods: This retrospective study was conducted using a 3T MRI scanner, incorporating a single-breath-hold axial gradient-echo sequence with prior cardiac monitoring. Targeted intestinal segments were pre-identified on T2-weighted images, and three distinct regions of interest (ROIs) were selected for quantitative analysis. Statistical analysis was performed using the Kolmogorov-Smirnov (KS) test to assess data distribution, paired Student’s t-test for intra-subject comparisons, and Pearson correlation to investigate relationships between imaging and laboratory parameters, with statistical significance set at p<0.01.

Results: Qualitative evaluation of intestinal wall thickening using non-contrast T2-weighted sequences identified significant findings in 15 out of the 18 patients included, with an average thickness of 9.5 ± 2.5 mm. No significant deviations from normality were found in the KS test for normal (p=0.21) and thickened (p=0.11) walls. Quantitative analysis of T2-mapping revealed a mean value of 51.8 ± 9.4 ms for normal wall segments, whereas thickened segments demonstrated a significantly elevated value of 105.6 ± 4.3 ms (p<10⁻⁶).

Conclusion: T2-mapping presents a robust, quantitative approach for assessing intestinal inflammation in patients contraindicated for contrast agents, offering a reliable alternative for disease monitoring and longitudinal follow-up.