Diffusion-weighted magnetic resonance for assessing ileal Crohn's disease activity

Antonino Caruso, Renata D'Incà, Marco Scarpa, Paolo Manfrin, Massimo Rudatis, Anna Pozza, Imerio Angriman, Andrea Buda, Giacomo Carlo Sturniolo, Carmelo Lacognata

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Endoscopy and imaging objectively assess Crohn's disease (CD) activity. Magnetic resonance enterography (MRE) uses no ionizing radiation, carries no significant morbidity, and is highly sensitive in revealing soft tissues inflammation. Diffusion-weighted imaging can distinguish intestinal inflammation from a lower diffusion of water molecules giving rise to a reduced apparent diffusion coefficient. The magnetic resonance index of activity score and, more recently, the Clermont score were recently developed for staging CD activity. The aim of this study was to compare the MRE scores and the Simple Endoscopic Score for CD in identifying ileal CD activity. Methods: Fifty-five patients with ileal and ileocolonic CD were consecutively enrolled between June 2012 and June 2013. All patients underwent clinical examination, biochemical tests, MRE, and colonoscopy to assess disease activity. Results: MRE assessed active ileal disease in 31 patients (56.3%). The Clermont score significantly correlated with the magnetic resonance index of activity score (r = 0.91; P <0.0001) and the Simple Endoscopic Score for CD (r = 0.76; P <0.0001). The apparent diffusion coefficient correlated with the Simple Endoscopic Score for CD (r = 20.63; P <0.0001) especially in unoperated patients. Conclusions: The Clermont score and the apparent diffusion coefficient value can stage ileal CD, avoiding the need to use contrast agents.

Original languageEnglish
Pages (from-to)1575-1583
Number of pages9
JournalInflammatory Bowel Diseases
Volume20
Issue number9
DOIs
Publication statusPublished - Dec 1 2014

Keywords

  • ADC and clermont
  • Crohn's disease
  • Diffusion-weighted imaging
  • Magnetic resonance imaging
  • MaRIA

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy
  • Medicine(all)

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