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Magnetic resonance imaging compared with ileocolonoscopy in evaluating disease severity in Crohn's disease
Jasper Florie1, Karin Horsthuis, Daniel W Hommes
1Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands. j.florie@amc.uva.nl
Background & Aims:
Abdominal magnetic resonance imaging (MRI) has shown promising results in the detection of Crohn's disease (CD)-related lesions. The purpose of this study was to assess the value of MRI in measuring disease activity in CD patients in comparison with ileocolonoscopy.
Methods:
Thirty-one patients undergoing ileocolonoscopy because of suspicion of relapsing CD underwent MRI with water as intraluminal contrast medium. At endoscopy, disease severity was graded (4-point scale), and Crohn's Disease Endoscopic Index of Severity (CDEIS) was determined. Two radiologists independently interpreted the MRI scans. Radiologic grading (4-point scale) was compared with endoscopic grading of disease severity and CDEIS (overall, for all segments). Wall thickness and enhancement were compared with CDEIS. Patient experience and preference were determined.
Results:
In, respectively, 14 and 14 patients (radiologist 1) and 16 and 11 patients (radiologist 2) an exact match or 1 level of difference in grading was scored with the endoscopist. Correlation between severity rated at MRI and CDEIS was moderate to strong with r = 0.61 (P < .001) for observer 1 and r = 0.63 (P < .001) for observer 2. Per segment, best correlation was seen in the terminal ileum (r = 0.63; P < .001, for both observers). Wall thickness correlated moderately to strongly with CDEIS (r = 0.57, P < .001 and r = 0.50, P < .001 for observers 1 and 2), whereas enhancement correlated weakly to moderately (r = 0.45, P < .001 and r = 0.42, P < .001). Patients experienced more pain during endoscopy, and all patients except 2 preferred MRI to endoscopy.
Conclusion:
MRI can correctly identify disease severity in patients with CD and is a patient-friendly alternative to ileocolonoscopy.
Insights
Abdominal MRI accurately measures Crohn's disease (CD) activity, showing moderate to strong correlation with endoscopic severity scores. Patients preferred MRI over ileocolonoscopy due to less discomfort, making it a patient-friendly alternative for CD assessment.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
- Radiology
Background:
- Abdominal MRI shows promise for detecting Crohn's disease (CD) lesions.
- Assessing CD activity is crucial for effective patient management.
Purpose of the Study:
- To evaluate the accuracy of MRI in measuring CD disease activity.
- To compare MRI findings with ileocolonoscopy results.
Main Methods:
- 31 patients with suspected relapsing CD underwent MRI with water contrast.
- Disease severity was graded via endoscopy (CDEIS) and compared to MRI interpretations by two radiologists.
- Wall thickness and enhancement on MRI were correlated with CDEIS scores.
Main Results:
- MRI grading showed moderate to strong correlation with CDEIS (r=0.61-0.63).
- The terminal ileum demonstrated the strongest correlation between MRI and CDEIS.
- Patients reported less pain with MRI and preferred it over ileocolonoscopy.
Conclusions:
- Abdominal MRI is effective in assessing Crohn's disease severity.
- MRI offers a patient-preferred, less invasive alternative to ileocolonoscopy for CD evaluation.
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