Ileal Crohn's disease: MRI with endoscopic correlation

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Crohn's disease (CD) activity assessment typically relies on invasive endoscopic procedures.
• Accurate staging of CD is crucial for effective treatment and management.
• Non-invasive imaging modalities are sought to complement or replace endoscopy.

Purpose of the Study:

• To evaluate the efficacy of MR-enterography (MRE) for activity staging in Crohn's disease (CD).
• To compare MRE findings with ileoscopy, using the SES-CD score as the reference standard.
• To determine the reliability of a novel MRI activity score for CD staging.

Main Methods:

• A prospective study included 61 patients diagnosed with CD.
• All participants underwent both MRE and ileoscopy.
• An ad hoc MRI activity score and imaging analysis were compared against the ileoscopic SES-CD score, using a 1.0 T scanner.

Main Results:

• The developed MRI score demonstrated high accuracy in discriminating active from inactive CD (AUC=0.941).
• Moderate to strong correlation was observed between the MRI score and the SES-CD score (Spearman's r=0.62, p<0.001).
• Good agreement (Cohen's κ=0.60) was found in staging ileal CD activity (inactive, mild, moderate-to-severe) between MRE and ileoscopy.

Conclusions:

• The novel MRI score is a reliable predictor of disease activity in ileal CD.
• MRE staging of ileal Crohn's disease activity is comparable to endoscopic staging.
• 1.0 T MRI scans are validated for radiological assessment of ileal CD.