Jordi Rimola1, Ingrid Ordás, Sonia Rodríguez, Elena Ricart, Julián Panés. 1. Department of Radiology, Centro de Investigaciones Biomédicas en Red, Enfermedades Hepáticas y Digestivas, IDIBAPS, Hospital Clínic of Barcelona, Villarroel 170, 08036 Barcelona, Spain. jrimola@clinic.ub.es
Abstract
BACKGROUND: Cross-sectional imaging techniques, including ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) are increasingly used for evaluation of Crohn's disease (CD). AIM: To review the accuracy of cross-sectional imaging indexes for measurement of disease activity and severity in patients with CD, and to evaluate its applicability on daily clinical practice and research. METHODS: Relevant publications were identified by literature search, and selected based on predefined quality parameters, including a sample size and reference standard. Nineteen publications were chosen. RESULTS: The US-based indexes of activity showed high correlation with reference standard indexes. There is a good or very good agreement between the MR-based indexes and the reference standard when the comparison is limited to small segments of intestine. Significant discrepancies have been found between indexes that evaluate the colon. Only one CT-based index was included. The main strengths and weaknesses of the indexes, according to its design, are discussed. CONCLUSION: Standardization of image acquisition protocols and patient preparation should be procured, especially for MRI. In daily practice, a simple, semi-quantitative index providing relevant information on disease activity and severity is preferable. For research purposes, a precise and reproducible index should be mandatory.
BACKGROUND: Cross-sectional imaging techniques, including ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) are increasingly used for evaluation of Crohn's disease (CD). AIM: To review the accuracy of cross-sectional imaging indexes for measurement of disease activity and severity in patients with CD, and to evaluate its applicability on daily clinical practice and research. METHODS: Relevant publications were identified by literature search, and selected based on predefined quality parameters, including a sample size and reference standard. Nineteen publications were chosen. RESULTS: The US-based indexes of activity showed high correlation with reference standard indexes. There is a good or very good agreement between the MR-based indexes and the reference standard when the comparison is limited to small segments of intestine. Significant discrepancies have been found between indexes that evaluate the colon. Only one CT-based index was included. The main strengths and weaknesses of the indexes, according to its design, are discussed. CONCLUSION: Standardization of image acquisition protocols and patient preparation should be procured, especially for MRI. In daily practice, a simple, semi-quantitative index providing relevant information on disease activity and severity is preferable. For research purposes, a precise and reproducible index should be mandatory.
Authors: Jesica C Makanyanga; Doug Pendsé; Nikolaos Dikaios; Stuart Bloom; Sara McCartney; Emma Helbren; Elaine Atkins; Terry Cuthbertson; Shonit Punwani; Alastair Forbes; Steve Halligan; Stuart A Taylor Journal: Eur Radiol Date: 2013-09-12 Impact factor: 5.315
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