Magnetic Resonance Imaging Predicts Histopathological Composition of Ileal Crohn’s Disease

Wagner, Mathilde; Ko, Huaibin M.; Chatterji, Manjil; Besa, Cecilia; Torres, Joana; Zhang, Xiaofei; Panchal, Hinaben J.; Hectors, Stefanie; Cho, Judy H.; Colombel, Jean–Frédéric; Harpaz, Noam; Taouli, Bachir

doi:10.1093/ecco-jcc/jjx186

Cited by 49 publications

(45 citation statements)

References 42 publications

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“…It was uncertain whether the degree of inflammation should optimally be determined using validated endoscopic scores. Panelists rated the following imaging features, reflecting the inflammatory component of a small bowel stricture on cross‐sectional imaging, as appropriate: mural hyperenhancement, presence of ulcers, co‐existence with penetrating disease, perienteric fat stranding, comb sign and intramural T2 hyperintensity (for MRE only) …”

Section: Resultsmentioning

confidence: 99%

An expert consensus to standardise definitions, diagnosis and treatment targets for anti‐fibrotic stricture therapies in Crohn's disease

Rieder¹,

Bettenworth²,

et al. 2018

Aliment Pharmacol Ther

166

167

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Section: Resultsmentioning

confidence: 99%

An expert consensus to standardise definitions, diagnosis and treatment targets for anti‐fibrotic stricture therapies in Crohn's disease

Rieder¹,

Bettenworth²,

et al. 2018

Aliment Pharmacol Ther

166

167

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“…However, Orlando et al[ 44 ] found no association between baseline BWT at US and therapeutic outcomes. Moreover, abnormal BWT detected at MRE (as a result of fibrosis and fibromuscular hyperplasia) may persist in the absence of a significant active inflammatory component[ 17 ], reflecting BD[ 70 , 71 ]. Some authors consider that extramural lesions should also be included in TH[ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Treat-to-target in Crohn’s disease: Will transmural healing become a therapeutic endpoint?

Serban

2018

WJCC

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Crohn’s disease (CD) represents a chronic transmural inflammatory condition of the gastrointestinal tract, which usually leads to structural damage and significant disability. Deep remission - defined by both clinical and endoscopic remission, signifying mucosal healing - represents the current endpoint in the treat-to-target strategy, significantly improving patients’ long-term outcomes. Transmural healing (TH) could be a more effective target, but this possibility remains unclear. This narrative review aims to critically review and summarize the available literature relating TH to long-term outcomes, being the first of its kind and to the best of the author’s knowledge. A systematic literature search (from inception to March 31 2018) was performed, using multiple databases, and identifying seven full-text manuscripts. In those studies, long-term favorable outcomes (≥ 52 wk) included sustained clinical remission, as well as fewer therapeutic changes, CD-related hospitalizations, and surgeries. Despite heterogeneous design and methodological limitations, six of the studies demonstrated that TH or intestinal healing (TH plus mucosal healing) were predictive for the aforementioned favorable outcomes. Therefore, TH may become a reasonable therapeutic target and be included in the concept of deep remission. Further prospective, well-designed, multicenter trials aiming to better define the role of TH in personalized therapy for CD and to determine the long-term influence of TH on bowel damage and disability are warranted.

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“…20 Table 1 summarizes the main characteristics of novel imaging modalities that had been investigated to detect and quantify fibrosis in CD, whereas Table 2 provides the evidence obtained in studies testing the techniques against histopathology. [9][10][11][13][14][15][21][22][23][24][25] To date, all the evidence comes from single-center studies with relatively small samples. Before these noninvasive quantitative imaging biomarkers can be widely implemented, further multicenter large-scale studies are needed to establish cutoff values, test their reproducibility, and determine their degree of interobserver agreement.…”

Section: Use (Swe Strain Ratio Arfi)mentioning

confidence: 99%

Differentiation of fibrotic and inflammatory component of Crohn’s disease-associated strictures

Rimola

Capozzi

2020

Intest Res

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Patients with Crohn’s disease (CD) commonly develop bowel strictures, which may contain various degrees of inflammation and fibrosis. While predominantly inflammatory strictures may benefit from a medical anti-inflammatory treatment approach, fibrotic strictures would require endoscopic balloon dilation or surgery. Cross-sectional imaging surpasses endoscopy for characterization of stenotic segments and potentially may contribute to the optimal clinical management of these patients. This short review aims to discuss the potentialities and limitations of cross-sectional imaging techniques for assessing bowel fibrosis in patients with CD.

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Magnetic Resonance Imaging Predicts Histopathological Composition of Ileal Crohn’s Disease

Abstract: MRI predicts the degree of inflammation, and can distinguish prominent muscle hypertrophy from prominent fibrosis in ileal CD with reasonable accuracy (area under receiver operating characteristic curve [AUROC] > 0.7).

Cited by 49 publications

References 42 publications

An expert consensus to standardise definitions, diagnosis and treatment targets for anti‐fibrotic stricture therapies in Crohn's disease

An expert consensus to standardise definitions, diagnosis and treatment targets for anti‐fibrotic stricture therapies in Crohn's disease

Treat-to-target in Crohn’s disease: Will transmural healing become a therapeutic endpoint?

Differentiation of fibrotic and inflammatory component of Crohn’s disease-associated strictures

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