Magnetic resonance imaging for evaluation of Crohnʼs disease

Rimola, Jordi; Ordás, Íngrid; Rodríguez, Sónia; García-Bosch, Orlando; Aceituno, Montserrat; Llach, Josep; Ayuso, Carmen; Ricart, Elena; Panés, Julián

doi:10.1002/ibd.21551

Cited by 422 publications

(193 citation statements)

References 21 publications

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“…Ideally, it would be interesting to evaluate a correlation among different parameters on multi-point scales; however, in the absence of a quantitative score for CTE, we preferred to adapt the clinical and endoscopic scale to the qualitative CTE score, using a 3-grade scale of severity, converting the numeric continuous values of HBi and SES-CD/Rutgeerts score in 3 categories as reported in the literature [9, 12, 13]. This limit of CTE scan could be resolved using magnetic resonance imaging (MRI), allowing a quantitative evaluation of transmural activity, through the use of the validated activity score MaRIA [24, 25]. However, when this study started, CTE was a more available technique compared to MRI; thus, we decided to include only patients undergoing to CTE.…”

Section: Discussionmentioning

confidence: 99%

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Laterza

Piscaglia

Minordi

et al. 2018

Dig Dis

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Aim: To evaluate if a single and/or combined (clinical, endoscopic and radiological) assessment could predict clinical outcomes in Crohn’s disease (CD). Methods: We prospectively evaluated 57 CD cases who underwent both a colonoscopy and a CT-enterography (CTE). Harvey-Bradshaw Index (HBi), SES-CD (and/or Rutgeerts score) and the radiological disease activity were defined to stratify patients according to clinical, endoscopic and radiological disease activity respectively. Hospitalizations, surgery, therapeutic changes and deaths were evaluated up to 36 months (time 1) for 53 patients. Results: CTE and endoscopy agreed in stratifying disease activity in 47% of cases (k = –0.05; p = 0.694), CTE and HBi in 35% (k = 0.09; p = 0.08), endoscopy and HBi in 39% (k = 0.13; p = 0.03). Taken together, CTE, endoscopy and HBi agreed only in 18% of cases (k = 0.01; p = 0.41). Among the 11 cases with mucosal healing, only 3 (27%) showed transmural healing. Patients with endoscopic activity needed significantly more changes of therapy compared to patients with endoscopic remission (p = 0.02). Patients with higher transmural or clinical activity at baseline required significantly more hospitalizations (p < 0.01). Hospitalization rate decreases with an increase in the number of parameters indicating remissions at baseline (p = 0.04). Conclusions: Clinical, endoscopic and radiological assessments offer complementary information and could predict different mid-term outcomes in CD.

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Section: Discussionmentioning

confidence: 99%

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Laterza

Piscaglia

Minordi

et al. 2018

Dig Dis

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“…In recent years, various MRE indices have been derived to evaluate disease activity in CD [4], but only the magnetic resonance index of activity (MaRIA) [5,6] and London indices [7] have been constructed using a structured process.…”

Section: Introductionmentioning

confidence: 99%

Comparison of three magnetic resonance enterography indices for grading activity in Crohn’s disease

et al. 2016

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Background Magnetic resonance enterography (MRE) is an accurate examination for assessing activity in Crohn's disease (CD). Various MRE indices have been developed for that purpose, but have not been directly compared. The aim of the study was to compare the diagnostic accuracy of three MRE indices for detecting and grading disease activity in CD, using endoscopy as gold standard. Methods MRE and ileocolonoscopies performed within 1 month in 43 patients with CD were analyzed. The magnetic resonance index of activity (MaRIA), Clermont, and London indices for each colonic segment and the terminal ileum were calculated. Simplified endoscopy score for CD (SES-CD) was considered the gold standard. Results Two hundred and twenty-four intestinal segments were included in the analysis. According to the established cut-off points for detecting active disease using MaRIA, Clermont, and London indices, the sensitivity of each index was 0.88, 0.89, and 0.71, and the specificity was 0.97, 0.78, and 0.99, respectively. The sensitivity for detecting ulcerations was 0.90 and 0.83 for the MaRIA and Clermont indices, respectively, with a specificity of 0.91 and 0.89. The AUROC curve for the MaRIA, Clermont, and London indices for detecting active disease was 0.92, 0.84, and 0.85, and for detecting ulcerations was 0.90 for the MaRIA, and 0.86 for Clermont index. Conclusions The three MRE-based indices evaluated in the current study have high diagnostic accuracy for assessment of disease activity. The MaRIA index has the best operational characteristics for detecting not only disease activity but also for grading severity, which supports its use in clinical studies and clinical practice.

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“…The accuracy of MRI for detection of activity is high, with a sensitivity of 93% and specificity of 90% [8,16,[23][24][25][26][27]. Similar diagnostic accuracy for both CT and MRI techniques has been shown in different studies that directly compare both imaging modalities [16,[27][28][29].…”

Section: Comparison Of Mri To Other Cross-sectional Imaging Techniquementioning

confidence: 68%

“…In contrast, MRI changes are similar in all colonic segments and terminal ileum, with the exception of enlarged lymph nodes that are predominantly associated with the presence of inflammatory lesions in the ascending colon and terminal ileum [6,8]. The earliest macroscopic lesions of active CD are erythema and superficial aphthoid ulcerations [9].…”

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confidence: 92%

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MRI of Crohn’s disease: from imaging to pathology

et al. 2011

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Technological advances in the area of magnetic resonance imaging (MRI) raised expectations on the potential role of this imaging modality for evaluation of the gastrointestinal tract, especially on Crohn's disease (CD), based on the high spatial and tissue resolution as well as lack of ionizing radiation. Available evidence indicates that MRI has a high diagnostic accuracy for the detection of disease activity, location of the lesions, and also for determining the severity of the disease, which together are the main aspects for the therapeutic decision-making in patients with CD. MRI provides a high accuracy in detection of strictures, characterization of fistulizing lesions and extraluminal complications such us abscesses which are a key finding for considering medical and surgical options. Knowledge of the pathological substrate of inflammatory lesions in CD as well as extraenteric lesions may improve diagnostic image interpretation, and thus contribute to optimize patient care.

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Magnetic resonance imaging for evaluation of Crohnʼs disease

Abstract: The MRI variables that should be evaluated in clinical practice to diagnose active CD and severe CD are validated, as well as the quantitative index of activity for use in research studies.

Cited by 422 publications

References 21 publications

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Comparison of three magnetic resonance enterography indices for grading activity in Crohn’s disease

MRI of Crohn’s disease: from imaging to pathology

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