MRI Evaluation of Inflammatory Activity in Crohn's Disease

We wanted to assess the capability of MRI to quantitatively evaluate the therapeutic response to Crohn's disease (CD) relapse. Twenty patients with histologically proven CD were prospectively evaluated with MRI and ileocolonoscopy over a 2-year period. The MRI protocol included axial and corona...

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Bibliographic Details
Published in:	American journal of roentgenology (1976) Vol. 184; no. 6; pp. 1829 - 1835
Main Authors:	Sempere, G. A. Javier, Martinez Sanjuan, Vicente, Medina Chulia, Enrique, Benages, Adolfo, Tome Toyosato, Alicia, Canelles, Pilar, Bulto, Antonio, Quiles, Francisco, Puchades, Iciar, Cuquerella, Jaime, Celma, Julian, Orti, Elisa
Format:	Journal Article
Language:	English
Published:	Leesburg, VA Am Roentgen Ray Soc 01-06-2005 American Roentgen Ray Society
Subjects:	Adult Biological and medical sciences Case-Control Studies Colon - pathology Colonoscopy Contrast Media Crohn Disease - diagnosis Crohn Disease - pathology Female Follow-Up Studies Gadolinium DTPA Gastroenterology. Liver. Pancreas. Abdomen Humans Ileum - pathology Magnetic Resonance Imaging Male Medical sciences Middle Aged Other diseases. Semiology Prospective Studies Recurrence Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Time Factors Crohn disease Digestive diseases Medical imagery Intestinal disease Nuclear magnetic resonance imaging Inflammatory disease
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Summary:	We wanted to assess the capability of MRI to quantitatively evaluate the therapeutic response to Crohn's disease (CD) relapse. Twenty patients with histologically proven CD were prospectively evaluated with MRI and ileocolonoscopy over a 2-year period. The MRI protocol included axial and coronal T2-weighted and contrast-enhanced T1-weighted sequences. MRI examinations were performed twice, once during an acute relapse of CD and the other at clinical remission. The terminal ileum and colon were divided into six segments/patient, and the endoscopy and histology findings were considered the standard of reference. These were compared on a segmental basis with the quantitative MRI findings regarding wall thickness and contrast enhancement. The results obtained in active and remission CD phases were likewise compared with the findings in 10 control subjects who underwent complete ileocolonoscopy for other reasons and had no pathological findings on ileocolonoscopy. Fifty three of 120 (44.2%) bowel segments showed pathologic changes on endoscopy and histology consistent with CD in active phase. On changing from the active disease phase to clinical remission, a significant decrease was observed in the wall thickness and contrast enhancement of the affected bowel wall. In the active phase of CD, the pathologic bowel segments presented with significantly greater contrast enhancement and wall thickness values compared with the healthy segments of CD and controls. On converting clinically into remission, contrast enhancement tended to normalize, whereas bowel wall thickness remained increased compared with the controls. MRI is able to detect pathologic bowel segments in CD, as it allows the measurement of significant variations in wall thickness and contrast enhancement on changing from the active phase of the disease to remission.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0361-803X 1546-3141
DOI:	10.2214/ajr.184.6.01841829