Maria Chiara Colaiacomo MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To investigate the value of MRI in the overall assessment of Crohn's disease (disease activity, disease extension, complications). Methods and Materials: 95 consecutive patients with Crohn's Disease underwent MRI in the context of a clinical evaluation including biochemestry, endoscopy, histology and radiology. All patients underwent MRI after oral administration of a superparamagnetic contrast agent, using standard sequences (HASTE T2-weighted, with and without fat-suppression and Gd-enhanced T1-weighted FLASH). Two independent radiologists evaluated MR images on printed films. For a morphological assessment of the disease the bowel was divided into 7 segments (jejunum, ileum, right, transverse, descending, sigmoid colon and rectum). Disease length, presence of strictures, fistulae, abscesses, phlegmons and any other abdominal complication were evaluated at the level of each segment. Gold Standard (GS) for morphological assessment were: barium studies, CT or US, and surgery when performed. At the level of the affected segments we also evaluated and graded (0-3) bowel wall thickness, T1 wall Gd-enhancement, T2 wall signal, T2 fibro-fatty proliferation signal, to assesses disease activity. GS for disease activity were endoscopy, biological activity and CDAI. Results: MRI detected 90% of overall disease length, 75% of fistulae, 92% of strictures; adhesions were overestimated. In 12% of patients MRI showed complications requiring surgery (1 hydronephrosis, 3 abscesses, 4 phlegmons, 1 pancreatic duct stone, 1 enterovescical fistula, 2 ovarian involvements). The following MRI findings were statistically correlated with the clinical and biological signs of active disease: bowel wall thickness (r:0.59), wall Gd-enhancement (r:0.84), T2 wall signal (r:0.80), T2 fibro-fatty proliferation signal (r:0.76). Conclusion: MRI, giving reliable information on different aspects of the disease (activity, extension, complications), can influence the planning of medical and surgical therapy.       Questions about this event email: francesca.maccioni@uniroma1.it

Colaiacomo MD, M, Role of MR Imaging in the Assessment of Patients with Crohn's Disease.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3106144.html