BACKGROUND: Magnetic resonance imaging (MRI) is considered the imaging standard for diagnosis and characterization of perianal complications associated with Crohn disease in children and adults. OBJECTIVE: To define MRI criteria that could act as potential predictors of treatment response in fistulizing Crohn disease in children, in order to guide more informed study interpretation. MATERIALS AND METHODS: We performed a retrospective database query to identify all children and young adults with Crohn disease who underwent serial MRI studies for assessment of perianal symptoms between 2003 and 2010. We examined imaging features of perianal disease including fistula number, type and length, presence and size of associated abscess, and disease response/progression on follow-up MRI. We reviewed imaging studies and electronic medical records. Statistical analysis, including logistic regression, was performed to associate MR imaging features with treatment response and disease progression. RESULTS: We included 36 patients (22 male, 14 female; age range 8-21 years). Of these, 32 had a second MRI exam and 4 had clinical evidence of complete response, obviating the need for repeat imaging. Of the parameters analyzed, presence of abscess, type of fistula according to the Parks classification, and multiplicity were not predictors of treatment outcome. Maximum length of the dominant fistula and aggregate fistula length in the case of multiple fistulae were the best predictors of treatment outcome. Maximum fistula length <2.5 cm was a predictor of treatment response, while aggregate fistula length ≥2.5 cm was a predictor of disease progression. CONCLUSION: Perianal fistula length is an important imaging feature to assess on MRI of fistulizing Crohn disease.
BACKGROUND: Magnetic resonance imaging (MRI) is considered the imaging standard for diagnosis and characterization of perianal complications associated with Crohn disease in children and adults. OBJECTIVE: To define MRI criteria that could act as potential predictors of treatment response in fistulizing Crohn disease in children, in order to guide more informed study interpretation. MATERIALS AND METHODS: We performed a retrospective database query to identify all children and young adults with Crohn disease who underwent serial MRI studies for assessment of perianal symptoms between 2003 and 2010. We examined imaging features of perianal disease including fistula number, type and length, presence and size of associated abscess, and disease response/progression on follow-up MRI. We reviewed imaging studies and electronic medical records. Statistical analysis, including logistic regression, was performed to associate MR imaging features with treatment response and disease progression. RESULTS: We included 36 patients (22 male, 14 female; age range 8-21 years). Of these, 32 had a second MRI exam and 4 had clinical evidence of complete response, obviating the need for repeat imaging. Of the parameters analyzed, presence of abscess, type of fistula according to the Parks classification, and multiplicity were not predictors of treatment outcome. Maximum length of the dominant fistula and aggregate fistula length in the case of multiple fistulae were the best predictors of treatment outcome. Maximum fistula length <2.5 cm was a predictor of treatment response, while aggregate fistula length ≥2.5 cm was a predictor of disease progression. CONCLUSION: Perianal fistula length is an important imaging feature to assess on MRI of fistulizing Crohn disease.
Authors: Chiara Villa; Giovanni Pompili; Giuseppe Franceschelli; Alice Munari; Giovanni Radaelli; Giovanni Maconi; Gian Paolo Cornalba Journal: Eur J Radiol Date: 2011-02-11 Impact factor: 3.528
Authors: Saurabh Kedia; Raju Sharma; Govind K Makharia; Vineet Ahuja; Devendra Desai; Devasenathipathy Kandasamy; Anu Eapen; Karthik Ganesan; Uday C Ghoshal; Naveen Kalra; D Karthikeyan; Kumble Seetharama Madhusudhan; Mathew Philip; Amarender Singh Puri; Sunil Puri; Saroj K Sinha; Rupa Banerjee; Shobna Bhatia; Naresh Bhat; Sunil Dadhich; G K Dhali; B D Goswami; S K Issar; V Jayanthi; S P Misra; Sandeep Nijhawan; Pankaj Puri; Avik Sarkar; S P Singh; Anshu Srivastava; Philip Abraham; B S Ramakrishna Journal: Indian J Gastroenterol Date: 2018-01-06
Authors: Noemi Maria Giovanna Ognibene; Massimo Basile; Marco Di Maurizio; Giuseppe Petrillo; Claudio De Filippi Journal: Radiol Med Date: 2016-02-02 Impact factor: 3.469
Authors: Phillip F C Lung; Kapil Sahnan; David Burling; James Burn; Phillip Tozer; Nuha Yassin; Samuel O Adegbola; Rachel Baldwin-Cleland; Janindra Warusavitarne; Arun Gupta; Omar Faiz; Robin K S Phillips; Ailsa L Hart Journal: Therap Adv Gastroenterol Date: 2018-08-30 Impact factor: 4.409