Rossano Girometti MD, Presenter: Nothing to Disclose

Lorenzo Cereser MD, Abstract Co-Author: Nothing to Disclose

Giuseppe Como MD, Abstract Co-Author: Nothing to Disclose

Chiara Zuiani MD, Abstract Co-Author: Nothing to Disclose

Massimo Bazzocchi MD, Abstract Co-Author: Nothing to Disclose

to investigate the value of a MRI scoring system including dynamic motility evaluation in assessing small bowel Crohn’s disease activity.

from March 2005 to December 2006 52 symptomatic patients with suspected Crohn’s disease onset or relapse underwent MRI on a 1.5T magnet. Bowel distension was achieved orally assuming a mean of 1.6L of a Poli-etylen-glicole (PEG) preparation. Per-patient assessment of disease activity was based on a scoring system including morphological and kinematic evaluation of the small bowel and perivisceral structures (true-FISP, cine-true-FISP and HASTE T2w sequences), and dynamic assessment of parietal contrast enhancement (VIBE T1w sequence). Patients were classified in three categories, using endoscopic biopsy as the standard reference: no activity/quiescent disease, mild activity, severe activity. Patients without terminal ileum involvement were excluded from data analysis.

MRI achieved a detailed and panoramic evaluation of the small bowel in all subjects examined. MRI correctly assessed 14/16 (87.5%) cases of no activity/quiescent disease, 12/14 (85.7%) cases of mild activity, and 15/15 (100%) cases of severe activity. Overall, activity score determined a per-patient misdiagnosis of disease activity in a not significant proportion of subjects (4/45; 8.8%) (p>0.05), determining 2 false-positive and 2 false-negative results of mild disease activity. Sensitivity, specificity, PPV, NPV and overall accuracy in assessing disease activity was 93.1%, 87.5%, 93.1%, 87.5% and 91.1%, repectively. The single more reliable parameter of the activity score was the degree of parietal contrast enhancement.

MRI follow-trough provides a highly accurate assessment of Crohn’s disease activity.

MRI is a promising tool in assessing Crohn’s disease activity, but to date no activity scores have proven suitable for everyday clinical use. A simple activity score to provide an overall interpretation of MRI findings of Crohn’s disease is proposed in this study.

Girometti, R, Cereser, L, Como, G, Zuiani, C, Bazzocchi, M, MRI Follow-through Evaluation in Patients with Crohn’s Disease of the Terminal Ileum Using an Activity Score Including Motility Study: Preliminary Results.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5010245.html