Tomas Ripolles MD, Abstract Co-Author: Nothing to Disclose

María Jesús Martinez, Abstract Co-Author: Nothing to Disclose

Paula Bartumeus, Presenter: Nothing to Disclose

Cristina Ramirez, Abstract Co-Author: Nothing to Disclose

Jose María Paredes, Abstract Co-Author: Nothing to Disclose

The purpose of this prospective study was twofold: to asses the efficacy of MRI and sonography in the assessment of CD activity in comparison with clinical scoring and biological tests and to compare both techniques in the evaluation of extension and transmural complications.

30 patients with histologically proven CD were prospectively examined the same day with both techniques, first sonography and after MRI. Sonographic exam included evaluation of bowel wall thickness, vascularity pattern and perienteric changes. Thirty minutes prior to MRI imaging, patients were given 250 ml of dilute sodium phosphate solution and additional 750 ml of water orally. MRI images evaluation also included bowel wall enhancement. The gastrointestinal tract was divided into five segments. Findings and extension of the both techniques were verified by means of enteroclysis, surgery or/and colonoscopy. The imaging findings were compared with clinical (CDAI) and laboratory data (CRP).

53 of 119 (45%) bowel segments showed pathological changes in gold standard tests. Sonography was superior to MRI in the localization of affected bowel segments (sensitivity: US 91%; MRI 83%; intertechniques agreement, kappa: 0.905) and in recognizing transmural complications (sensitivity: US 80%; MRI 72%), although significant differences were not found (p>0.005). There was a statistically significant correlation between color Doppler flow and bowel wall enhancement on MRI (p=0.891, segment-by-segment analysis). Wall thickness measured on sonography was significantly greater in the group of patients with clinical activity (p=0.023) or with clinic biological activity (p=0.024). No other significant correlation was found.

Both ultrasound and MRI are sensitive in localizing the affected bowel segments and detecting transmural complications in patients with Crohn´s disease. A significant correlation between color Doppler flow and bowel wall enhancement on MRI was found. Sonographic wall thickness reflected clinical or biological disease activity.

Our results show that sonography could be the first-choice modality in assesing disease activity and detecting small bowel abnormalities in patients with CD.

Ripolles, T, Martinez, M, Bartumeus, P, Ramirez, C, Paredes, J, Comparison of Ultrasound and MRI for Assessment of the Extension and the Inflammatory Activity in Patients with Crohn´s Disease.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5002613.html