Benjamin Don Spilseth MD, Presenter: Nothing to Disclose

Jeff L. Fidler MD, Abstract Co-Author: Medical Advisory Board, Bracco Group

David Bruining MD, Abstract Co-Author: Research Grant, Given Imaging Ltd Reseach Grant, F. Hoffman-La Roche Ltd Consultant, Bracco Group

Stephanie Hansel MD, Abstract Co-Author: Research support, Given Imaging Ltd Research support, Salix Pharmaceuticals, Inc

William S. Harmsen, Abstract Co-Author: Nothing to Disclose

Jordi Rimola MD, Abstract Co-Author: Consultant, Bristol-Myers-Squibb Company Consultant, F. Hoffmann-La Roche Ltd

David R Holmes PhD, Abstract Co-Author: Nothing to Disclose

Alan Larson, Abstract Co-Author: Nothing to Disclose

Shiv Pruthi, Abstract Co-Author: Nothing to Disclose

Joel Garland Fletcher MD, Abstract Co-Author: Grant, Siemens AG

The MaRIA score (MR Index of Activity) is a validated method for measuring the severity of Crohn’s disease enteric inflammation that is gaining widespread acceptance in the GI community, but does not take into account the length of enteric inflammation, which greatly impact patient function and disability. The purpose of our study was to determine if length of enteric inflammation improves the prediction of global and clinical Crohn’s disease severity scores compared to MaRIA alone.

30 patients with known Crohn’s disease underwent MR enterography within 30 days of ileocolonoscopy. Using a dedicated computer workstation, five colonic segments and 3 small bowel segments were systematically evaluated by two radiologists, who measured the MaRIA score and length of enteric inflammation using semi-automated tools for all inflamed bowel segments. A global physician score (GPS) of Crohn’s disease severity (ranging from 0-3) was created by a panel of gastroenterologists using ileocolonoscopy records, biopsy results, imaging reports, Harvey-Bradshaw index (HBI) scores, and C-reactive protein (CRP) was used as a reference standard.

For each reader, both MaRIA scores and lengths of enteric inflammation were significantly correlated with GPS (p < 0.0001), CRP (p <0.006), and HBI (p < 0.02). However, in multivariate logisitic regression analysis, neither MaRIA or length was independently predictive of GPS for one reader, and for the other, only length was independently predictive (p = 0.04). For both readers, there was a strong correlation between patient MaRIA scores and lengths of enteric inflammation (R = 0.87, 0.79).

Excellent correlation exists between global and clinical markers of Crohn’s disease severity and MaRIA scores and measured lengths of enteric inflammation. Because MaRIA scores are highly correlated with length of enteric inflammation, neither was independently predictive of global physician score for both readers in this small cohort. In larger patient cohorts, incorporation of length measurement will likely be useful in a future quantitative model.

Both the MaRIA score and measured lengths of enteric inflammation are highly related quantitative measures that correlate well with global assessment of Crohn’s disease severity.

Spilseth, B, Fidler, J, Bruining, D, Hansel, S, Harmsen, W, Rimola, J, Holmes, D, Larson, A, Pruthi, S, Fletcher, J, Global Patient Assessment of Crohn’s Disease Severity: Is MaRIA Sufficient, or Does Length of Enteric Inflammation Matter?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13022081.html