Crohn Disease: A 5-Point MR Enterocolonography Classification Using Enteroscopic Findings

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Crohn disease (CD) activity assessment is crucial for patient management.
• Current imaging scoring systems require validation for routine clinical use.
• Standardized MR enterocolonography interpretation is needed.

Purpose of the Study:

• To establish the efficacy of a novel 5-point MR enterocolonography classification for assessing CD activity.
• To compare this classification against the validated MR index of activity (MaRIA) score.
• To evaluate the concordance of MR findings with endoscopic assessments (CDEIS).

Main Methods:

• Retrospective enrollment of 120 patients with CD (70 derivation, 50 validation cohorts).
• Development of a 5-point MR enterocolonography classification based on visual assessment.
• Comparison of classification performance (AUCs) with MaRIA and endoscopic severity (CDEIS) for deep ulcer detection.

Main Results:

• The MR enterocolonography classification demonstrated high AUCs (89.0% derivation, 77.3-88.5% validation).
• Performance was statistically noninferior to the MaRIA score (p < 0.001).
• Good interobserver reproducibility was observed, indicating reliability.

Conclusions:

• The 5-point MR enterocolonography classification is an effective tool for evaluating CD activity in both small and large bowel segments.
• This classification offers a reliable alternative for assessing Crohn disease activity via MR enterocolonography.