RATIONALE AND OBJECTIVES: We sought to investigate the value of a MRI scoring system including dynamic motility evaluation in the assessment of small bowel Crohn's disease activity. MATERIALS AND METHODS: From March 2005 to December 2006, 52 patients with suspected Crohn's disease onset or relapse underwent MRI on a 1.5-T magnet. Bowel distention was achieved orally assuming a mean of 1.6 L of a polyethyleneglycol (PEG) preparation. Per-patient assessment of disease activity was based on a scoring system including evaluation of morphology and motility of the small bowel and perivisceral structures (true-FISP, cine-true-FISP, and HASTE T2W sequences) and dynamic assessment of parietal contrast enhancement (FLASH T1W sequence). Patients were included in three categories, using endoscopic biopsy as the standard reference: no activity/quiescent disease, mild activity, or moderate-to-severe activity. Patients without terminal ileum involvement were excluded from data analysis. RESULTS: MRI allowed a detailed and panoramic evaluation of the small bowel in all subjects examined. MRI properly assessed 14 of 16 (87.5%) cases of no activity/quiescent disease, 12 of 14 (85.7%) cases of mild activity, and 15 of 15 (100%) cases of severe activity. Overall, activity score led to a per-patient misdiagnosis of disease activity in a nonsignificant proportion of subjects (4 of 45; 8.8%) (P > .05), determining two false-positive and two false-negative results of mild disease activity. Sensitivity, specificity, PPV, NPV, and overall accuracy in assessing disease activity were 93.1%, 87.5%, 93.1%, 87.5%, and 91.1%, respectively. CONCLUSION: Accurate assessment of Crohn's disease activity is achieved by using an activity score providing an overall interpretation of MRI findings.
RATIONALE AND OBJECTIVES: We sought to investigate the value of a MRI scoring system including dynamic motility evaluation in the assessment of small bowel Crohn's disease activity. MATERIALS AND METHODS: From March 2005 to December 2006, 52 patients with suspected Crohn's disease onset or relapse underwent MRI on a 1.5-T magnet. Bowel distention was achieved orally assuming a mean of 1.6 L of a polyethyleneglycol (PEG) preparation. Per-patient assessment of disease activity was based on a scoring system including evaluation of morphology and motility of the small bowel and perivisceral structures (true-FISP, cine-true-FISP, and HASTE T2W sequences) and dynamic assessment of parietal contrast enhancement (FLASH T1W sequence). Patients were included in three categories, using endoscopic biopsy as the standard reference: no activity/quiescent disease, mild activity, or moderate-to-severe activity. Patients without terminal ileum involvement were excluded from data analysis. RESULTS: MRI allowed a detailed and panoramic evaluation of the small bowel in all subjects examined. MRI properly assessed 14 of 16 (87.5%) cases of no activity/quiescent disease, 12 of 14 (85.7%) cases of mild activity, and 15 of 15 (100%) cases of severe activity. Overall, activity score led to a per-patient misdiagnosis of disease activity in a nonsignificant proportion of subjects (4 of 45; 8.8%) (P > .05), determining two false-positive and two false-negative results of mild disease activity. Sensitivity, specificity, PPV, NPV, and overall accuracy in assessing disease activity were 93.1%, 87.5%, 93.1%, 87.5%, and 91.1%, respectively. CONCLUSION: Accurate assessment of Crohn's disease activity is achieved by using an activity score providing an overall interpretation of MRI findings.
Authors: Alex Menys; David Atkinson; Freddy Odille; Asia Ahmed; Marco Novelli; Manuel Rodriguez-Justo; Ian Proctor; Shonit Punwani; Steve Halligan; Stuart A Taylor Journal: Eur Radiol Date: 2012-06-03 Impact factor: 5.315
Authors: Johannes M Froehlich; Christian Waldherr; Christoforos Stoupis; S Mehmet Erturk; Michael A Patak Journal: Eur Radiol Date: 2010-04-09 Impact factor: 5.315
Authors: Parakkal Deepak; Amy B Kolbe; Jeff L Fidler; Joel G Fletcher; John M Knudsen; David H Bruining Journal: Gastroenterol Hepatol (N Y) Date: 2016-04
Authors: L Macarini; L P Stoppino; A Centola; S Muscarella; F Fortunato; F Coppolino; N Della Valle; V Ierardi; P Milillo; R Vinci Journal: Radiol Med Date: 2012-06-28 Impact factor: 3.469