Diffusion‐weighted magnetic resonance imaging for detecting and assessing ileal inflammation in <scp>C</scp>rohn's disease

Buisson, Anthony; Joubert, Aurélie; Montoriol, P.F.; Ines, D. Da; Hordonneau, Constance; Pereira, Bruno; Garcier, J.M.; Bommelaer, Gilles; Petitcolin, V.

doi:10.1111/apt.12201

Cited by 180 publications

(154 citation statements)

References 34 publications

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“…Intravenous gadolinium is associated with rare but serious adverse effects such as hypersensitivity reactions and nephrogenic systemic sclerosis [Rose and Choi, 2015]. The correlation between both MRE scores was excellent, as described previously [Buisson et al 2013, Hordonneau et al 2014.…”

Section: Discussionsupporting

confidence: 70%

“…A segmental MaRIA score was calculated using the following formula: MaRIA = 1.5 × wall thickness (mm) + 0.02 × relative contrast enhancement + 5 × edema + 10 × ulcers [Rimola et al 2009]. Similarly, a segmental Clermont score was calculated using the following formula: Clermont = −1.32 × ADC (10 −3 mm 2 /s) + 1.646 × wall thickness (mm) + 8.306 × ulcers + 5.613 × edema + 5.039 [Buisson et al 2013]. For the purpose of MaRIA and Clermont score calculation, the distal SB was defined as the distal 20 cm of the terminal ileum.…”

Section: Patient Populationmentioning

confidence: 99%

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Magnetic resonance enterography versus capsule endoscopy activity indices for quantification of small bowel inflammation in Crohn’s disease

Kopylov

Klang

Yablecovitch

et al. 2016

Therap Adv Gastroenterol

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Background: Video capsule endoscopy (VCE) and magnetic resonance enterography (MRE) are the prime modalities for the evaluation of small bowel (SB) Crohn's disease (CD). Mucosal inflammation on VCE is quantified using the Lewis score (LS). Diffusion-weighted (DW) magnetic resonance imaging (MRI) allows for accurate assessment of SB inflammation without administration of intravenous contrast material. The Magnetic Resonance Index of Activity (MaRiA) and the Clermont index are quantitative activity indices validated for contrast-enhanced MRE and DW-MRE, respectively. The aim of this study was to compare the quantification of distal SB inflammation by VCE and MR-related activity indices. Methods: Patients with known quiescent SB CD were prospectively recruited and underwent MRE and VCE. LS, MaRIA and Clermont scores were calculated for the distal SB. Results: Both MRI-based indices significantly correlated with the LS and the Clermont index (r = 0.50, p = 0.001 and r = 0.53, p = 0.001, respectively). Both MaRIA and Clermont scores were significantly lower in patients with mucosal healing (LS < 135). The area under the curve (AUC) with both MR scores was moderate for prediction of any mucosal inflammation (LS ⩾ 135) and excellent for prediction of moderate-to-severe inflammation (LS ⩾ 790) (0.71 and 0.74 versus 0.93 and 0.91 for MaRIA and Clermont score, respectively). Conclusions: Modest correlation between VCE-and MRE-based quantitative indices of inflammation in patients with quiescent SB CD was observed. Between-modality correlation was higher in patients with endoscopically severe disease. DW-MRE gauged by Clermont score was at least as accurate as contrast-enhanced MRE for quantification of SB inflammation.

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Section: Discussionsupporting

confidence: 70%

Section: Patient Populationmentioning

confidence: 99%

Magnetic resonance enterography versus capsule endoscopy activity indices for quantification of small bowel inflammation in Crohn’s disease

Kopylov

Klang

Yablecovitch

et al. 2016

Therap Adv Gastroenterol

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“…Buisson & Hordonneau [33,34] have found a strong correlation between the two indices in patients with colonic involvement and, although to a lesser degree, of the distal ileum; furthermore has been found good correlation with Clermont score but these quantitative measures are still in process of validation, being understood that these study are limited because didn't use endoscopic findings as reference.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performances of Diffusion-Weighted Magnetic Resonance Imaging in the Evaluation of Fibrosis and Post-Operative Endoscopic Recurrence in Crohn’s Disease

Samperi¹

2016

GHOA

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Background: Diffusion-weighted represents a new application of magnetic resonance imaging (DW-MRI) to assess inflammatory activity in Crohn's disease. ADC is a quantitative parameter of this phenomenon. We aimed to verify the correlation between DWI findings both with pathological evaluation of fibrosis in surgical specimen both with endoscopic recurrence.Methods: 31 pts undergoing ileocolonic resection for CD were submitted to DW-MRI. Conventional MRI findings of terminal or neo-terminal ileum were recorded together with a semiquantitative evaluation of DWI signal intensity and with ADC calculation. For the first aim, Acute Inflammatory (AIS) and Fibrostenosis score was correlated to ADC values of matched ileo-cecal segment. ROC curves analysis was used to find out an ADC cut-off value able to distinguish "low and high grade" severity of post-operative recurrence. Results:Comparison of DWI findings with surgical specimens pathologic evaluation showed a very good correlation, inverse and statistically significant, between ADC and AIS total (r=-0.90, p=0.013). The mean ADC value of the 5 pts with fibrosis was not statistically different from the 5 pts without. The comparison between ADC and Rutgeerts'score showed a good correlation, inverse and statistically significant (rho= -0.73, P=0.002). ROC curves analysis highlighted that a value of ADC ≤ 1.82 x10 -3 mm 2 /s could predict a severe recurrence (Rs >i2) with a sensitivity of 88.9% and a specificity of 83.3%. Conclusion:This study showed the ability of DWI sequences to provide quantitative measures of inflammation, allowing a more objective assessment of CD. Further studies should clarify whether ADC evaluation could predict the presence of fibrosis in surgical specimens.

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“…These studies were interesting but included only small samples of adults or did not use a well-defined gold standard. Buisson et al, 37 in a prospective study including 31 adult patients, showed excellent sensitivity (SE 5 100%) of DWI as compared with conventional MRE. The NPV was 100%.…”

Section: A Retrospective Study By Oto Et Al In 2009mentioning

confidence: 93%

Prospective evaluation of free-breathing diffusion-weighted imaging for the detection of inflammatory bowel disease with MR enterography in childhood population

Dubron¹,

Avni²,

Boutry³

et al. 2016

BJR

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Diffusion‐weighted magnetic resonance imaging for detecting and assessing ileal inflammation in Crohn's disease

Abstract: SUMMARY BackgroundWhether diffusion-weighted imaging (DWI)-MRI is of value in detecting and assessing inflammation of ileal Crohn's disease (CD) remains poorly investigated.

Cited by 180 publications

References 34 publications

Magnetic resonance enterography versus capsule endoscopy activity indices for quantification of small bowel inflammation in Crohn’s disease

Magnetic resonance enterography versus capsule endoscopy activity indices for quantification of small bowel inflammation in Crohn’s disease

Diagnostic Performances of Diffusion-Weighted Magnetic Resonance Imaging in the Evaluation of Fibrosis and Post-Operative Endoscopic Recurrence in Crohn’s Disease

Prospective evaluation of free-breathing diffusion-weighted imaging for the detection of inflammatory bowel disease with MR enterography in childhood population

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