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Assessing pediatric ileocolonic Crohn's disease activity based on global MR enterography scores
Fabio Pomerri1, Faise Al Bunni2, Monica Zuliani3
1Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy. fabio.pomerri@unipd.it.
Insights
Magnetic resonance enterography (MRE) scores, including MaRIA and MEGS, effectively correlate with clinical indicators of pediatric Crohn's disease (CD) activity. These MRE-based scores show promise as non-invasive tools for monitoring disease severity in children with CD.
Area of Science:
- Pediatric Gastroenterology
- Radiology
- Inflammatory Bowel Disease Research
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease affecting children.
- Accurate assessment of disease activity and severity is crucial for effective management.
- Current monitoring methods like endoscopy can be invasive for pediatric patients.
Purpose of the Study:
- To correlate magnetic resonance index of activity (MaRIA) and magnetic resonance enterography global score (MEGS) with established clinical activity indexes in pediatric CD.
- To evaluate the utility of MRE-based scores as non-invasive tools for assessing CD activity and severity in children.
Main Methods:
- Retrospective analysis of 32 pediatric patients with confirmed CD who underwent magnetic resonance enterography (MRE).
- Correlation analysis between MRE-derived scores (MaRIA, MEGS) and clinical/biochemical markers: simplified endoscopic score for CD (SES-CD), pediatric Crohn's disease activity index (PCDAI), and C-reactive protein (CRP).
- Comparison of MaRIA and MEGS between pediatric patients with mild versus moderate/severe CD activity based on PCDAI.
Main Results:
- Global MaRIA showed significant correlation with SES-CD (r=0.70, p=0.001) and PCDAI (r=0.42, p=0.016).
- MEGS correlated significantly with PCDAI (r=0.46, p=0.007) and CRP levels (r=0.35, p=0.046).
- MEGS demonstrated a significant difference (p=0.027) between pediatric patients categorized by clinical disease severity.
Conclusions:
- MRE-based global scores (MaRIA and MEGS) are reliable indicators of Crohn's disease activity in pediatric patients.
- These MRE scores show potential as valuable, non-invasive tools for predicting CD activity and severity.
- MRE offers a promising alternative to endoscopy for monitoring pediatric CD patients during follow-up.
Objectives:
This study was aimed at correlating a magnetic resonance index of activity (MaRIA) and a magnetic resonance enterography global score (MEGS) with activity indexes in a paediatric population with Crohn's disease (CD).
Methods:
This retrospective study included 32 paediatric patients (median age 14.5 years, 18 male) with proven CD who underwent magnetic resonance enterography (MRE). A correlation analysis was performed on the MRE-based scores, the simplified endoscopic score for CD (SES-CD), the paediatric Crohn's disease activity index (PCDAI), and C-reactive protein (CRP) levels. Based on PCDAI, comparison of both global MaRIA and MEGS was made between patients with mild and moderate/severe disease activity.
Results:
Global MaRIA correlated with SES-CD (r = 0.70, p = 0.001) and PCDAI (r = 0.42, p = 0.016). MEGS correlated with PCDAI (r = 0.46, p = 0.007) and CRP levels (r = 0.35, p = 0.046). MEGS differed significantly (p = 0.027) between patients grouped by clinical disease severity.
Conclusions:
MRE-based global scores correlated with clinical indexes of CD activity. Therefore, they represent a potential useful tool to predict CD activity and severity, as well as a possible promising alternative to endoscopy, to monitor paediatric patients with CD during their follow-up.
Key Points:
• MRE is widely used to for accurate assessment of CD. • Global MaRIA and MEGS have been suggested as indicators of CD activity. • Paediatric studies comparing MRE-based global scores with clinical CD activity are lacking. • Such scores can serve as predictors of CD activity/severity in paediatric patients. • MRE offers an alternative to clinical score/endoscopy for paediatric CD monitoring.
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