Diffusion-Weighted Magnetic Resonance Imaging in Ileocolonic Crohn's Disease: Validation of Quantitative Index of Activity

Hordonneau, Constance; Buisson, Anthony; Scanzi, Julien; Goutorbe, Félix; Pereira, Bruno; Borderon, Corinne; Ines, D. Da; Montoriol, P.F.; Garcier, Jean-Marc; Boyer, L.; Bommelaer, Gilles; Petitcolin, V.

doi:10.1038/ajg.2013.385

Cited by 188 publications

(213 citation statements)

References 19 publications

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“…It is also important to underline that in line with the cutoff used in our study to predict the presence of post-operative recurrence of high degree, other authors [34,12] have found similar cut-off, respectively, 1.9 × 10ˉ ³mm²/s and 2.0 x 10ˉ ³mm²/s, capable of discriminating between active and non-active CD in the small intestine, with a sensitivity ranging from 84% and 86% and a specificity between 82% and 91%, while in Buisson's study [35] an ADC<1.88 x 10-3 mm2/s was capable to distinguish superficial endoscopic ulcerations with a Se=64% and a Spe=75% and an ADC<1.42 x 10-3 mm2/s recognised endoscopic deep ulcers with Se=91% and Spe=83%.…”

Section: Post-surgical Recurrence's Evaluationsupporting

confidence: 71%

“…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%

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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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Section: Post-surgical Recurrence's Evaluationsupporting

confidence: 71%

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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“…The utility of MRE for quantitative evaluation of SB inflammation in CD is established [Rimola et al 2009[Rimola et al , 2011Ordas et al 2014]; a novel MRE-based index [Magnetic Resonance Index of Activity (MaRIA) score] demonstrated significant correlation with the Crohn's Disease Endoscopic Index of Activity (CDEIS) [Rimola et al 2011;Ordas et al 2014]. Diffusion-weighted (DW)-MRE yields comparable performance and does not require intravenous contrast material [Hordonneau et al 2014]. The DW-MRE-based Clermont index, which incorporates the apparent diffusion coefficient (ADC), was recently validated in distal SB CD and was strongly correlated with MaRIA and the Simple Endoscopic Score for CD (SES-CD) [Caruso et al 2014].…”

Section: Introductionmentioning

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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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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“…Taigi gydymo efektyvumui įvertinti reikalingas išsamus gleivinės ir žarnos sienelės stebėjimas. Panašu, kad šiuo metu MRE -geriausia alternatyva endoskopiniam tyrimui [8].…”

Section: Rezultatų Aptarimasunclassified

MRT Difuzijos Reikšmė Diagnozuojant Krono Ligą

Strakšytė

Gineikienė

Mikšaitė

et al. 2015

Medicinos Teorija Ir Praktika

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SANTRAUKAReikšminiai žodžiai: ADC, difuzija, uždegiminės žarnyno ligos, magnetinio rezonanso tomografijos tyrimas. Įvadas. Dėl geros minkštųjų audinių raiškos, magnetinio rezonanso enterokolonografijos tyrimas vis dažniau naudojamas diagnozuojant Krono ligą. Difuzijos seka padeda pastebėti ir diferencijuoti segmentinius žarnos pažeidimus bei suteikia papildomos informacijos apie žarnų sienelės funkcinius pakitimus. Tyrimo tikslas: Įvertinti tariamojo difuzijos koeficiento vertę sveikuose ir Krono ligos pažeistuose žarnos segmentuose. Medžiaga ir metodai. Tyrimo imtį sudaro trisdešimt trys pacientai, sergantys Krono liga, kurie nuo 2013 m. rugsėjo iki 2014 m. kovo mėnesio gydėsi Lietuvos sveikatos mokslų universiteto ligoninės Kauno klinikų Gastroenterologijos klinikoje. Visiems pacientams buvo atliktas magnetinio rezonanso enterokolonografijos tyrimas naudojant standartines magnetinio rezonanso bei difuzijos sekas. Rezultatai. Tyrimo metu nustatyti 55 pakitę plonosios ir storosios žarnos segmentai, iš jų 28 plonojoje žarnoje: 2 -tuščiojoje, 5 -pradinėje klubinės žarnos dalyje, 21 -galinėje klubinėje žarnoje ir 27 storojoje žarnoje: 4 -kylančiojoje storosios žarnos dalyje, 6 -skersinėje, 8 -nusileidžiančioje, 9 -tiesiosios-riestinės žarnų dalyse. Aktyvia Krono liga sirgo 18 pacientų, 15 pacientų nustatyta neaktyvi ligos forma -remisija. Aktyvaus ir neaktyvaus uždegimo segmentuose tariamo difuzijos koeficiento vertė skyrėsi statistiškai patikimai: 0,8862 ± 0,077 x 10 -3 mm 2 /s ir 0,9925 ± 0,077 x 10 -3 mm 2 /s; p < 0,05. Išvada. Atlikus tyrimą paaiškėjo, kad tariamojo difuzijos koeficiento vertės patikimai skiriasi dėl uždegimo pakitusiuose ir sveikuose žarnyno segmentuose.

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Diffusion-Weighted Magnetic Resonance Imaging in Ileocolonic Crohn's Disease: Validation of Quantitative Index of Activity

Abstract: DW-MREC is a reliable tool to assess inflammation in colonic (ADC) and ileal (Clermont score) CD and its use in daily practice would avoid gadolinium injection.

Cited by 188 publications

References 19 publications

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

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

MRT Difuzijos Reikšmė Diagnozuojant Krono Ligą

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