Agreement between real-time elastography and delayed enhancement magnetic resonance enterography on quantifying bowel wall fibrosis in Crohn's disease

Stefano Mazza, Francesco Simone Conforti, Laura Virginia Forzenigo, Nicole Piazza, Roberto Bertè, Andrea Costantino, Mirella Fraquelli, Marina Coletta, Jordi Rimola, Maurizio Vecchi, Flavio Caprioli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: the assessment of fibrosis in Crohn's disease (CD) bowel lesions helps to guide therapeutic decisions. Real-time elastography (RTE) and delayed-enhancement magnetic resonance enterography (DE-MRE) have demonstrated good accuracy in quantifying CD-related ileal fibrosis as compared with histological examination. To date no study has compared DE-MRE and RTE. Aims: we aimed to evaluate the agreement between RTE and DE-MRE on quantifying CD-related ileal fibrosis. Methods: consecutive patients with ileal or ileocolonic CD underwent RTE and DE-MRE. Ileal fibrosis was quantified by calculating the strain ratio (SR) at RTE and the 70s-7 min percentage of enhancement gain (%EG) of both mucosa and submucosa at DE-MRE. A SR ≥2 was applied to define severe fibrosis. Clinically relevant outcomes occurring at follow-up were recorded. Results: 40 CD patients were enrolled. A significant linear correlation was observed between SR and submucosal %EG (r = 0.594, p < 0.001). Patients with severe fibrosis (SR ≥2) had significantly higher submucosal %EG values than patients with low/moderate fibrosis (median values 26.4% vs. 9.5%, p < 0.001). During a median 43.8-month follow-up relevant disease outcomes occurred more frequently in the severe-fibrosis group (75% vs. 36%, HR 5.4, 95% CI 1.2–24.6, p = 0.029). Conclusions: the study demonstrates an excellent agreement between RTE and DE-MRE in assessing ileal fibrosis in CD.

Original languageEnglish
JournalDigestive and Liver Disease
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Crohn's disease
  • Fibrosis
  • Magnetic resonance imaging
  • Real-time elastography

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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