Neeraja Mahalingam1, Jean A Tkach2,3,4, Lee A Denson5,6, Jonathan R Dillman2,3,4. 1. Department of Radiology, Imaging Research Center, Cincinnati Children's Hospital Medical Center, 250 Albert Sabin Way, Cincinnati, OH, USA. Neeraja.Mahalingam@cchmc.org. 2. Department of Radiology, Imaging Research Center, Cincinnati Children's Hospital Medical Center, 250 Albert Sabin Way, Cincinnati, OH, USA. 3. Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 4. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 5. Divsion of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 6. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Abstract
PURPOSE: To compare bowel wall T1 relaxation estimates in young patients with newly diagnosed ileal CD to healthy control participants, characterize their change over time in response to biologic medical therapy, and evaluate their associations with clinical markers of intestinal inflammation. MATERIALS AND METHODS: Patients with newly diagnosed ileal CD and healthy control participants were prospectively recruited between December 2018 and October 2021. Patients underwent research MRI examinations of the bowel at baseline and at 6-weeks and 6-months into biologic medical treatment; control participants underwent single MRI examinations. MRI examinations included native T1 relaxometry of the terminal ileum using a modified Look-Locker inversion recovery (MOLLI) sequence. T1 estimates were measured on scanner-generated parametric maps. Clinical markers of intestinal inflammation were recorded at each visit. Group differences were assessed using the Mann-Whitney U test; the Friedman test was used to assess longitudinal changes in T1 estimates. Spearman correlation was used to evaluate associations between T1 estimates and inflammatory markers. RESULTS: Nineteen participants with CD (12 males; median age 14 years) and 15 control participants (7 males; median age 17 years) were included in the study. Bowel wall T1 estimates in CD patients (median 1302 ms) were significantly longer compared to control participants (median 1159 ms) (p < 0.001). In CD patients, T1 estimates changed over time after treatment (p = 0.001), with largest reductions between baseline and 6-weeks (p < 0.001). T1 estimates correlated with inflammatory markers, including erythrocyte sedimentation rate (ρ = 0.35; p = 0.01), c-reactive protein level (ρ = 0.34; p = 0.02), and weighted Pediatric Crohn's Disease Activity Index (ρ = 0.39; p = 0.005). T1 estimates did not correlate with serum albumin (ρ = - 0.28; p = 0.051) and fecal calprotectin (ρ = 0.07; p = 0.63). CONCLUSION: Bowel wall T1 estimates are abnormally increased in newly diagnosed ileal CD patients and decrease in response to medical therapy.
PURPOSE: To compare bowel wall T1 relaxation estimates in young patients with newly diagnosed ileal CD to healthy control participants, characterize their change over time in response to biologic medical therapy, and evaluate their associations with clinical markers of intestinal inflammation. MATERIALS AND METHODS: Patients with newly diagnosed ileal CD and healthy control participants were prospectively recruited between December 2018 and October 2021. Patients underwent research MRI examinations of the bowel at baseline and at 6-weeks and 6-months into biologic medical treatment; control participants underwent single MRI examinations. MRI examinations included native T1 relaxometry of the terminal ileum using a modified Look-Locker inversion recovery (MOLLI) sequence. T1 estimates were measured on scanner-generated parametric maps. Clinical markers of intestinal inflammation were recorded at each visit. Group differences were assessed using the Mann-Whitney U test; the Friedman test was used to assess longitudinal changes in T1 estimates. Spearman correlation was used to evaluate associations between T1 estimates and inflammatory markers. RESULTS: Nineteen participants with CD (12 males; median age 14 years) and 15 control participants (7 males; median age 17 years) were included in the study. Bowel wall T1 estimates in CD patients (median 1302 ms) were significantly longer compared to control participants (median 1159 ms) (p < 0.001). In CD patients, T1 estimates changed over time after treatment (p = 0.001), with largest reductions between baseline and 6-weeks (p < 0.001). T1 estimates correlated with inflammatory markers, including erythrocyte sedimentation rate (ρ = 0.35; p = 0.01), c-reactive protein level (ρ = 0.34; p = 0.02), and weighted Pediatric Crohn's Disease Activity Index (ρ = 0.39; p = 0.005). T1 estimates did not correlate with serum albumin (ρ = - 0.28; p = 0.051) and fecal calprotectin (ρ = 0.07; p = 0.63). CONCLUSION: Bowel wall T1 estimates are abnormally increased in newly diagnosed ileal CD patients and decrease in response to medical therapy.
Authors: Eric I Benchimol; Kyle J Fortinsky; Peter Gozdyra; Meta Van den Heuvel; Johan Van Limbergen; Anne M Griffiths Journal: Inflamm Bowel Dis Date: 2011-01 Impact factor: 5.325
Authors: Conor G Loftus; Edward V Loftus; W Scott Harmsen; Alan R Zinsmeister; William J Tremaine; L Joseph Melton; William J Sandborn Journal: Inflamm Bowel Dis Date: 2007-03 Impact factor: 5.325
Authors: Ingrid Ordás; Jordi Rimola; Sonia Rodríguez; José M Paredes; María J Martínez-Pérez; Esther Blanc; Juan A Arévalo; Marta Aduna; Montserrat Andreu; Alexander Radosevic; Anna M Ramírez-Morros; Susana Pinó; Marta Gallego; Aranzazu Jauregui-Amezaga; Elena Ricart; Julián Panés Journal: Gastroenterology Date: 2013-10-29 Impact factor: 22.682
Authors: Seunghyun Lee; Young Hun Choi; Yeon Jin Cho; Jung-Eun Cheon; Jin Soo Moon; Gyeong Hoon Kang; Woo Sun Kim Journal: Eur Radiol Date: 2020-02-20 Impact factor: 5.315
Authors: C Cellier; T Sahmoud; E Froguel; A Adenis; J Belaiche; J F Bretagne; C Florent; M Bouvry; J Y Mary; R Modigliani Journal: Gut Date: 1994-02 Impact factor: 23.059