Jordi Rimola MD, Presenter: Nothing to Disclose

Ingrid Ordas, Abstract Co-Author: Nothing to Disclose

Esther Blanc, Abstract Co-Author: Nothing to Disclose

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

Carmen Ayuso, Abstract Co-Author: Nothing to Disclose

Julián Panés, Abstract Co-Author: Nothing to Disclose

To assess the ability of MRI to reflect therapy-induced changes in Crohn’s disease (CD) inflammatory lesions, using ileocolonoscopy as reference standard.

Patients with active CD (CDAI>200), and ulcers in at least one segment at ileocolonoscopy, received corticosteroids (n=7) or adalimumab (n=24) for induction of remission. Colonic and ileal disease activity was assessed by a previously validated Magnetic Resonance Index of Activity (MaRIA), endoscopy (CDEIS), clinical evaluation (CDAI), and biomarkers at baseline and week 12 after initiation of therapy.

31 patients have completed the study. Clinical remission (CDAI <150) was achieved in 5/7 patients treated with steroids and 17/24 of those treated with adalimumab. Mucosal healing (CDEIS <3.5) was observed in 2/7 steroid treated patients and 17/24 adalimumab treated patients. Complete healing of all segments with ulcers detected by endoscopy at baseline was observed in 2/7 patients treated with steroids and 13/24 treated with adalimumab. On a segment-by-segment analysis, a significant correlation was observed between CDEIS and MaRIA both at baseline (r=0.78 Pearson p<0.001) and at week12 (r=0.76 Pearson, p<0.001). The magnitude of reduction in MaRIA closely paralleled changes in CDEIS (r=0.6; p<0.01). A global MaRIA score ≤40 predicted endoscopic remission (CDEIS < 7) (sensitivity=0.73; specificity=1). The kappa coefficient between endoscopical and MRI healing (MaRIA< 11) was 0.79 ±0.057 (p<0.001).

Conclusion: MRI is an accurate method to assess therapeutic responses in CD, sensitive to changes in lesion severity, and able to determine mucosal healing.

Assessment of mucosal healing in CD is relevant for predicting the course of the disease and guide therapeutic choices.

Rimola, J, Ordas, I, Blanc, E, Rodriguez, S, Ayuso, C, Panés, J, Mucosal Healing in Crohns Disease: Assessment of Therapeutic Response by MRI and Ileo-Colonoscopy in a Prospective Multicentric Study.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004543.html