Non-perforating small bowel Crohn's disease assessed by MRI enterography: derivation and histopathological validation of an MR-based activity index.
Eur J Radiol
; 81(9): 2080-8, 2012 Sep.
Article
em En
| MEDLINE
| ID: mdl-21924572
ABSTRACT
OBJECTIVES:
To develop and validate a qualitative scoring system for enteric Crohn's disease activity using MR enterography (MRE).METHODS:
MRE was performed in 16 patients (mean age 33, 8 male) undergoing small bowel resection. Mural thickness, T2 signal, contrast enhancement, and perimural oedema were scored qualitatively (0-3) at 44 locations. Transmural histopathological scoring of acute inflammation (AIS) was performed at all locations (score 0-13). MRI parameters best predicting AIS were derived using multivariate analysis. The MRI activity index was applied to 26 Crohn's patients (mean age 32, range 13-69 years, 15 male) and correlated to terminal ileal biopsy scores of acute inflammation ("eAIS" score 1-6). Receiver operator characteristic curves were calculated.RESULTS:
Mural thickness (coefficient 1.34 (95% CI 0.36, 2.32)], p=0.007) and T2 signal (coefficient 0.90 (95% CI -0.24, 2.04) p=0.06) best predicted AIS (AIS=1.79+1.34*mural thickness+0.94*mural T2 score [R-squared 0.52]). There was a significant correlation between the MRI index and eAIS (Kendall's tau=0.40, 95% CI 0.11-0.64, p=0.02). The model achieved a sensitivity of 0.81 (95% CI 0.54-0.96), specificity of 0.70 (0.35-0.93) and AUC 0.77 for predicting acute inflammation (eAIS ≥2).CONCLUSIONS:
A simple qualitative MRI Crohn's disease activity score appears predictive against a histopathological standard of reference.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Índice de Gravidade de Doença
/
Algoritmos
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Imageamento por Ressonância Magnética
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Interpretação de Imagem Assistida por Computador
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Doença de Crohn
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Intestino Delgado
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
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Qualitative_research
Limite:
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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Middle aged
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article