Derivation of a T2-weighted MRI total colonic inflammation score (TCIS) for assessment of patients with severe acute inflammatory colitis—a preliminary study

Abstract

MRI TCIS falls after therapy, correlates with existing markers of disease severity, and in comparison may better predict therapeutic response.

Review article: dose optimisation of infliximab for acute severe ulcerative colitis

“…Small bowel distention on plain abdominal radiography during the acute admission predicts an increased risk of colectomy . Pilot data in 22 patients with acute severe UC undergoing unprepared MRI demonstrated that the total colonic inflammatory score had a positive predictive value for colectomy, although availability of this modality in the acute setting is a substantial limitation to this approach . .…”

“…although availability of this modality in the acute setting is a substantial limitation to this approach. 73 Interventions: Both serum CRP and infliximab concentrations have been associated with the risk of colectomy during infliximab induction treatment, however, the proposed cut-offs differ widely amongst studies. 32,44,74,75 Given the multiple factors influencing infliximab drug exposure, a personalised approach to initial and subsequent dosing should be informed by a population-based pharmacokinetic model that would account for dynamic changes in parameters such as serum CRP and albumin concentrations (Figure 3).…”

Review article: the practical management of acute severe ulcerative colitis

“…A potential role for colonic MRI has been explored in the literature. The total colonic inflammation score (TCIS) was devised to enable standardised MRI assessment of severity and prognosis in ASUC . The score, ranging from 6 to 95, was derived from radiologist assessment of T2‐weighted images, on the basis of segmental haustral loss, mural thickness, oedema and colonic dilatation.…”

“…The total colonic inflammation score (TCIS) was devised to enable standardised MRI assessment of severity and prognosis in ASUC. 44 The score, ranging from 6 to 95, was derived from radiologist assessment of T2-weighted images, on the basis of segmental haustral loss, mural thickness, oedema and colonic dilatation. TCIS on admission was shown to correlate with levels of CRP (Kendall's tau = 0.45, 95% CI: 0.11-0.79, P = 0.006), and stool frequency (Kendall's tau = 0.39, 95% CI: 0.14-0.64, P = 0.02).…”

Is abdominal CT useful for the management of patients with severe acute colitis complicating inflammatory bowel disease? A study in 54 consecutive patients

“…We reported that colectomy was performed in 76% of our patients. This rate of colectomy for SAC is slightly higher than reported for other series (14-46%) [13,21]. However, patients received surgery after a median delay of 6 (0-53) days, as recommended by ECCO Guidelines.…”