[Quantifying the inflammatory activity in Crohn's disease using CE dynamic MRI].

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Crohn's disease is a chronic inflammatory bowel disease.
• Accurate assessment of local inflammatory activity is crucial for effective management.
• Dynamic contrast-enhanced MRI (DCE-MRI) offers potential for non-invasive evaluation.

Purpose of the Study:

• To evaluate the efficacy of dynamic contrast-enhanced MRI in assessing local inflammatory activity in patients with Crohn's disease.
• To correlate MRI findings with established disease activity indices.

Main Methods:

• Prospective study involving 13 patients with histologically confirmed Crohn's disease.
• Acquisition of axial and coronal MRI slices using a 1.5 T scanner, including T1, T2, and dynamic T1 sequences post-contrast administration.
• Contrast uptake analysis through semiquantitative scoring and region of interest (ROI) evaluation, correlated with Crohn's Disease Activity Index (CDAI) and Severe Activity Index (SAI).

Main Results:

• Contrast uptake in the intestinal wall was observed with a mean time to uptake of 18.5 seconds and plateau phase onset at 16.1 seconds.
• Maximum contrast enhancement reached 266% of baseline, with a plateau phase observed in all cases.
• Significant correlations were found between maximum contrast uptake, time to plateau phase, and CDAI (r=0.591, p=0.033; r=0.562, p=0.046 respectively).

Conclusions:

• Dynamic contrast-enhanced MRI is a valuable tool for quantifying local bowel wall inflammation in Crohn's disease.
• The method demonstrates significant correlation with disease activity indices, supporting its potential clinical utility.
• Larger studies are recommended to establish DCE-MRI in routine clinical practice for Crohn's disease management.