| Assessment of activity of Crohn's disease of the ileum and large bowel: proposal for a new multiparameter MR enterography score. | |
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MedLine Citation:
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PMID: 22744346 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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 AND METHODS: 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. |
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Authors:
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L Macarini; L P Stoppino; A Centola; S Muscarella; F Fortunato; F Coppolino; N Della Valle; V Ierardi; P Milillo; R Vinci |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-6-28 |
Journal Detail:
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Title: La Radiologia medica Volume: - ISSN: 1826-6983 ISO Abbreviation: - Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-6-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0177625 Medline TA: Radiol Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Diagnostic Imaging, University of Foggia, Viale Luigi Pinto 1, 71100, Foggia, Italy. |
Vernacular Title:
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Valutazione dell'attività di malattia del morbo di Crohn dell'ileo e dell'intestino crasso: proposta di un nuovo score E-RM multiparametrico. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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