Feasibility of evaluating Crohn's disease activity at 3.0 Tesla

Abstract

Purpose: To determine whether abdominal 3.0T MRI can be used for evaluation of Crohn's disease (CD) compared with ileocolonoscopy (CS), and to determine patient preference for MRI as opposed to CS. Materials and Methods:Twenty patients scheduled for CS underwent MRI. At CS, disease severity was graded and the Crohn's Disease Endoscopic Index of Severity (CDEIS) was determined. Radiological grading (by two observers) was compared with endoscopic grading and CDEIS. Patient experience and preference were determined. Results:In respectively 10 (observer 1) and 13 patients (observer 2) exact agreement between radiological and endoscopic grading was found. In respectively 10 and 7 patients radiological and endoscopic grading differed one level. No statistically significant correlation was found between radiological grading and CDEIS. Between bowel wall thickness and CDEIS weak to moderate correlations were found, and between bowel wall enhancement and CDEIS weak correlations were found. All patients preferred MRI over CS. Conclusion:It is feasible to perform abdominal 3.0T MRI using orally administered contrast medium for evaluation of CD, and this method can be considered a patient-friendly alternative to CS.

Magnetic resonance imaging for evaluation of disease activity in Crohn’s disease: a systematic review

“…Finally, seven papers [17,18,[28][29][30][31][32] fulfilled all inclusion criteria and were used for data extraction and data analysis (Appendix 1). There was no disagreement regarding inclusion between the two reviewers.…”

“…In three of the seven included studies, only patients with CD were evaluated [17,31,32]. In the other four studies, both patients with CD and with ulcerative colitis were included [18,[28][29][30].…”

“…However, different appraisals were used to determine pathological bowel wall enhancement; in the older studies percentages of contrast enhancement were used (post-and precontrast MRI), with higher ratios indicating more severe disease [28,29]. In other studies subjective enhancement was used to stage disease [17,18,[30][31][32]. With regard to bowel wall thickening, cutoff values to indicate the different stages of disease were provided only in one study [30].…”

“…Data were reported on a per-patient basis in five studies [28][29][30][31][32] and on a per-segment basis in two studies [17,18]. For the studies reporting segmental data, we grouped the available segmental data per patient to enable data analysis on a per-patient basis; only bowel segments that were inspected endoscopically or surgically were included, and the most severe segmental score was used for analysis.…”

“…For the studies reporting segmental data, we grouped the available segmental data per patient to enable data analysis on a per-patient basis; only bowel segments that were inspected endoscopically or surgically were included, and the most severe segmental score was used for analysis. In four studies distinction was made among remission, mild, moderate and severe disease [28,29,31,32]; in two studies only remission, mild and frank disease were distinguished [17,18]. In one study numerical scores from 0 to 4 were given with stages 1 and 2 representing mild disease and stages 3 and 4 representing frank disease [30].…”