Assessment of activity of Crohn's disease of the ileum and large bowel: proposal for a new multiparameter MR enterography score.
Radiol Med
; 118(2): 181-95, 2013 Mar.
Article
en En
| MEDLINE
| ID: mdl-22744346
ABSTRACT
PURPOSE:
We evaluated the diagnostic accuracy of magnetic resonance enterography (MR-E) in assessing Crohn's disease (CD) activity by differentiating acute, chronic and remission stages of disease through a quantitative MR-E assessment. MATERIALS ANDMETHODS:
One hundred patients with a histological diagnosis of CD were studied with MR-E. Intestinal distension was obtained by oral administration of approximately 2 L of a polyethylene glycol solution (PEG). In all cases, the ileum and large bowel were imaged with morphological sequences (heavily T2-weighted single-shot, dual fast-field echo, balanced fast-field echo) and a postcontrast dynamic sequence (T1-weighted high-resolution isotropic volume excitation). Disease activity was assessed according to a multiparameter score (0-8) based on lesion morphology, signal intensity and contrast enhancement. MR-E findings were compared with clinical-laboratory data and disease activity indices [Crohn's Disease Activity Index (CDAI); Inflammatory Bowel Disease Questionnaire (IBDQ)]. Multiple regression analysis was performed by correlating MR-E score, CDAI and IBDQ. Frequencies were then compared using the χ (2) test.RESULTS:
MR-E identified inactive disease in 9% of cases, chronic disease in 57% and active disease in the remaining 34%. The most frequently involved bowel segment was the terminal ileum (52%). A statistically significant correlation was found between MR-E score and CDAI (R=0.86; p<0.001) and between MR-E score and IBDQ (R=-0.83; p<0.001). The most suggestive parameter for disease activity was layered bowel-wall enhancement, a finding predominantly present in patients with increased CDAI (≥ 150) and/or local complications (χ (2)=7.13; p<0.01).CONCLUSIONS:
MR-E is a noninvasive and diagnostic imaging modality for CD study and follow-up. The MR-E score proposed in this study proved to be useful in assessing disease severity and monitoring response to treatment.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Imagen por Resonancia Magnética
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Enfermedad de Crohn
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Enfermedades del Íleon
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Intestino Grueso
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Aspecto:
Patient_preference
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Radiol Med
Año:
2013
Tipo del documento:
Article
País de afiliación:
Italia