Jordi Rimola MD, Presenter: Nothing to Disclose

Sonia Rodriguez-Gomez MD, Abstract Co-Author: Nothing to Disclose

Orlando Garcia-Bosch, Abstract Co-Author: Nothing to Disclose

Josefina Etchevers, Abstract Co-Author: Nothing to Disclose

Carmen Ayuso, Abstract Co-Author: Nothing to Disclose

Julián Panés, Abstract Co-Author: Nothing to Disclose

The objective of the current study was to determine the value of Magnetic Resonance Colonography (MRC) for assessment of colonic Crohn disease.

50 patients with clinically active or inactive Crohn disease underwent colonoscopy (considered as gold standard) and on the same day MRC using a 3. 0 T unit, after distending the colon with water. T2-weighted and pre- and post-contrast-enhanced T1-weighted sequences were acquired. Endoscopic lesions were graded as inactive –absence of lesions- mild/moderate –erythema, aphtae, superficial ulcers- or severe –deep ulceration-. The MRC parameters evaluated in each colonic segment were: wall thickness, pre- and post-contrast wall signal intensity, relative contrast enhancement, presence of edema, ulcers, and enlarged lymph nodes.

In all colonic segments, a progressive increase in the values of the parameters measured in correlation with disease severity was observed. A total of 213 colonic segments were available for evaluation. Significant differences (p<0.001) were found between inactive and mild/moderate disease, and between the latter and severe disease for wall thickness, signal post contrast, relative contrast enhancement, presence of edema and ulcers. Linear logistic regression analysis demonstrated that the variables with independent predictive value for determining disease activity and severity were wall thickness, relative contrast enhancement and presence of ulcers. Applying the corresponding coefficients, the sensitivity and specificity for detecting disease activity were 0.82 and 0.85, and for detection of severe lesions 0.92 and 0.92 respectively.

The high sensitivity and specificity of MRC for detection of disease activity and particularly for assessment of lesion severity bring about the possibility of using MRC as an alternative to endoscopy in the evaluation of colonic Crohn disease.

Assessment of disease extension and activity is crucial to guide therapy in IBD, and persistence of mucosal lesions, particularly when severe, are associated with unfavorable outcomes.

Rimola, J, Rodriguez-Gomez, S, Garcia-Bosch, O, Etchevers, J, Ayuso, C, Panés, J, Magnetic Resonance Is a Reliable Technique for Assessment of Disease Activity and Severity in Colonic Crohn Disease.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6011706.html