Magnetic Resonance Enterography

Stoddard, Paul B.; Ghazi, Leyla; Wong-You-Cheong, Jade J.; Cross, Raymond K.; Vandermeer, Fauzia Q.

doi:10.1097/mib.0000000000000186

Cited by 12 publications

(14 citation statements)

References 76 publications

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“…In fact, when endoscopic and MRE findings were compared for each intestinal segment, the correlation between SES‐CD score and MaRIA score was relatively weak than that of other segment if the rectum was not properly distended ( ρ = 0.499, p = 0.003) 31 . In addition, MRE cannot detect subtle and very early mucosal erosions and ulcerations, which can only be detected through ileocolonoscopy 38 . In our study, 8.9% (4/45) of patients with TH did not achieve EH.…”

Section: Discussionmentioning

confidence: 99%

Transmural healing evaluated by magnetic resonance enterography in paediatric patients with Crohn's disease receiving maintenance treatment with biologics

Choi

Kim

Jeon

et al. 2022

Aliment Pharmacol Ther

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Background:The optimal treatment goal in Crohn's disease (CD) is endoscopic healing (EH). However, transmural healing (TH) facilitated by the development and increasing performance of magnetic resonance enterography (MRE) is emerging as a potential treatment goal.Aims: To assess TH rates after 1 year of treatment by MRE and its relationship with EH in paediatric patients with CD receiving anti-tumour necrosis factor (TNF) agents, and to investigate factors associated with TH after 1 year of treatment.Methods: This multi-centre, prospective, observational study included Korean paediatric patients with luminal CD diagnosed at age < 19 years who were naïve to anti-TNF treatment. They simultaneously underwent ileocolonoscopy and MRE at baseline and after 1 year of treatment with biologics. Results:We included 116 patients. At 1 year, EH and TH were achieved in 59.5% (69/116) and 38.8% (45/116) of the patients, respectively. Both EH and TH was observed in 35.3% (41/116), EH without TH in 24.1% (28/116), TH without EH in 3.4% (4/116), and neither EH nor TH in 37.1% (43/116). Moreover, 59.4% (41/69) of patients who achieved EH at 1 year exhibited TH, and 91.1% (41/45) of patients who achieved TH exhibited EH. Baseline MaRIA score was associated with TH according to a multivariate analysis (OR 0.97, 95% CI 0.95-0.99, p = 0.023). Conclusion:TH is a more stringent goal than EH. Regular follow-up evaluation of transmural status, and efforts to achieve TH, may alter the natural course of CD in the era of treat-to-target.

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Section: Discussionmentioning

confidence: 99%

Transmural healing evaluated by magnetic resonance enterography in paediatric patients with Crohn's disease receiving maintenance treatment with biologics

Choi

Kim

Jeon

et al. 2022

Aliment Pharmacol Ther

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“…MR enterography can accurately display bowel-wall changes in early CD [51][52][53][54]. Characteristic bowel-wall changes suggesting active inflammation include bowelwall thickening, high T2 mural signal, mural hyper enhancement with mural stratification, and hyperemic vasa recta [55][56][57][58][59][60][61][62][63][64].…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

“…The performance of MR enterography for CD is very good. Rates of sensitivity and specificity are 77% to 82% and 80% to 100%, respectively [24,66,67]; MR enterography can accurately display bowel-wall changes in CD [51][52][53][54]. Characteristic bowel-wall changes suggesting active inflammation include bowel-wall thickening, high T2 mural signal, mural hyper enhancement with mural stratification, and hyperemic vasa recta [55][56][57][58][59][60][61][62][63][64].…”

Section: Variant 2: Known Crohn Disease Suspected Acute Exacerbationmentioning

confidence: 99%

ACR Appropriateness Criteria® Crohn Disease

Kim

Chang

Fowler

et al. 2020

Journal of the American College of Radiology

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Three common clinical scenarios involving use of imaging in Crohn disease are covered. These include the initial evaluation of Crohn disease when the diagnosis has not been previously established, the evaluation for anticipated exacerbation of known disease, and the evaluation of disease activity during therapy monitoring. The appropriateness of a given imaging modality for each scenario is rated as one of three categories (usually appropriate, may be appropriate, usually not appropriate) to help guide evaluation. Pediatric presentation of Crohn disease and the appropriateness of imaging are not covered in this document.

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“…Clinicians utilize different tests to monitor inflammatory burden and predict relapse in children with IBD. The most accurate methods include endoscopic evaluation, capsule endoscopy and magnetic resonance enterography; though, these options are invasive, costly, time consuming and can have associated complications[2-4]. Alternatively, less expensive and less invasive serum biomarkers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are also used to monitor inflammatory activity[5].…”

Section: Introductionmentioning

confidence: 99%

Consecutive fecal calprotectin measurements for predicting relapse in pediatric Crohn’s disease patients

Foster

Smyth

Lakhani

et al. 2019

WJG

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BACKGROUNDAsymptomatic children with Crohn’s disease (CD) require ongoing monitoring to ensure early recognition of a disease exacerbation.AIMIn a cohort of pediatric CD patients, we aimed to assess the utility of serial fecal calprotectin measurements to detect intestinal inflammatory activity and predict disease relapse.METHODSIn this prospective longitudinal cohort study, children with CD on infliximab therapy in clinical remission were included. Fecal calprotectin levels were assessed at baseline and at subsequent 2-5 visits. Clinical and biochemical disease activity were assessed using the Pediatric Crohn’s Disease Activity Index, C-reactive protein and erythrocyte sedimentation rate at baseline and at visits over the following 18 mo.RESULTS53 children were included and eighteen patients (34%) had a clinical disease relapse during the study. Baseline fecal calprotectin levels were higher in patients that developed symptomatic relapse [median (interquartile range), relapse 723 μg/g (283-1758) vs 244 μg/g (61-627), P = 0.02]. Fecal calprotectin levels > 250 μg/g demonstrated good predictive accuracy of a clinical flare within 3 mo (area under the receiver operator curve was 0.86, 95% confidence limits 0.781 to 0.937).CONCLUSIONRoutine fecal calprotectin testing in children with CD in clinical remission is useful to predict relapse. Levels > 250 μg/g are a good predictor of relapse in the following 3 mo. This information is important to guide monitoring standards used in this population.

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Magnetic Resonance Enterography

Cited by 12 publications

References 76 publications

Transmural healing evaluated by magnetic resonance enterography in paediatric patients with Crohn's disease receiving maintenance treatment with biologics

Transmural healing evaluated by magnetic resonance enterography in paediatric patients with Crohn's disease receiving maintenance treatment with biologics

ACR Appropriateness Criteria® Crohn Disease

Consecutive fecal calprotectin measurements for predicting relapse in pediatric Crohn’s disease patients

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