Diagnostic accuracy of magnetic resonance colonography for the evaluation of disease activity and severity in ulcerative colitis: a prospective study

Ordás, Íngrid; Rimola, Jordi; García-Bosch, Orlando; Rodríguez, Sónia; Gállego, Marta; Etchevers, María Josefina; Pellisé, María; Feu, Faust; González-Suárez, Begoña; Ayuso, Carmen; Ricart, Elena; Panés, Julián

doi:10.1136/gutjnl-2012-303240

Cited by 61 publications

(42 citation statements)

References 27 publications

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“…Cross-sectional imaging techniques currently have a restricted role in UC ( 62,153,154 ) (CEBM 2). Th us, imaging is not a target in these patients.…”

Section: Endoscopic Targetsmentioning

confidence: 99%

Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target

Peyrin–Biroulet

Sandborn

Sands

et al. 2015

American Journal of Gastroenterology

1,521

1,285

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“…Cross-sectional imaging techniques currently have a restricted role in UC ( 62,153,154 ) (CEBM 2). Th us, imaging is not a target in these patients.…”

Section: Endoscopic Targetsmentioning

confidence: 99%

Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target

Peyrin–Biroulet

Sandborn

Sands

et al. 2015

American Journal of Gastroenterology

1,521

1,285

View full text Add to dashboard Cite

show abstract

“…Use of diffusion-weighted imaging with magnetic resonance colonography (DWI-MRC)—a technique which assesses changes in water diffusion—has been reported to assist with the detection of colonic inflammation in UC without requiring a bowel preparation [20]. Most MRC protocols do require colonic distension with water or contrast enemas except with DWI-MRC [21]. MRI imaging applications and indications in UC are similar to CT, except bone strength assessments, which have not been validated with MRE.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Radiographical evaluation of ulcerative colitis

Deepak

2014

Gastroenterology Report

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Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis (UC). Imaging can be used non-invasively to determine the extent of involvement, severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease (IBD) manifestations. While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings, the use of computed tomography enterography (CTE) or magnetic resonance enterography (MRE) are now used as first-line investigations to exclude active small bowel disease in IBD patients and can be utilized to detect active colonic inflammation. Additionally, CT colonography and MR colonography are emerging techniques with potential applications in UC. Ultrasonography, leukocyte scintigraphy and positron emission tomography are novel abdominal imaging modalities currently being explored for IBD interrogations. This plethora of radiological imaging options has become a vital component of UC assessments.

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“…In many North American sites, MR enterography has replaced gastrointestinal fluoroscopy and computed tomography enterography and has become a first-line imaging test for suspected or extant IBD 30. Similarly, MR colonography has shown high accuracy for assessment of disease activity and severity in UC using objective MR imaging parameters including colonic contrast uptake, mural edema, enlarged lymph nodes, and the presence of engorged perienteric vasculature (comb sign) 31. As these MR findings correlate closely with endoscopy, this noninvasive study may be considered as an adjunct or alternative to colonoscopy in selected cases, particularly when colonoscopy is contraindicated or incomplete due to clinically severe illness.…”

Section: Initial Approach In Consideration Of New-onset Ucmentioning

confidence: 99%

Current approaches to the management of new-onset ulcerative colitis

Beery¹,

Kane²

2014

CEG

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Ulcerative colitis (UC) is an idiopathic, inflammatory gastrointestinal disease of the colon. As a chronic condition, UC follows a relapsing and remitting course with medical maintenance during periods of quiescent disease and appropriate escalation of therapy during times of flare. Initial treatment strategies must not only take into account current clinical presentation (with specific regard for extent and severity of disease activity) but must also take into consideration treatment options for the long-term. The following review offers an approach to new-onset UC with a focus on early treatment strategies. An introduction to the disease entity is provided along with an approach to initial diagnosis. Stratification of patients based on clinical parameters, disease extent, and severity of illness is paramount to determining course of therapy. Frequent assessments are required to determine clinical response, and treatment intensification may be warranted if expected improvement goals are not appropriately reached. Mild-to- moderate UC can be managed with aminosalicylates, mesalamine, and topical corticosteroids with oral corticosteroids reserved for unresponsive cases. Moderate-to-severe UC generally requires oral or intravenous corticosteroids in the short-term with consideration of long-term management options such as biologic agents (as initial therapy or in transition from steroids) or thiopurines (as bridging therapy). Patients with severe or fulminant UC who are recalcitrant to medical therapy or who develop disease complications (such as toxic megacolon) should be considered for colectomy. Early surgical referral in severe or refractory UC is crucial, and colectomy may be a life-saving procedure. The authors provide a comprehensive evidence-based approach to current treatment options for new-onset UC with discussion of long-term therapeutic efficacy and safety, patient-centered perspectives including quality of life and medication compliance, and future directions in related inflammatory bowel disease care.

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Diagnostic accuracy of magnetic resonance colonography for the evaluation of disease activity and severity in ulcerative colitis: a prospective study

Abstract: MRC has a high accuracy for the diagnosis of disease activity and severity in UC.

Cited by 61 publications

References 27 publications

Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target

Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target

Radiographical evaluation of ulcerative colitis

Current approaches to the management of new-onset ulcerative colitis

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