Francesca Maccioni MD, Presenter: Nothing to Disclose

Najwa Alansari, Abstract Co-Author: Nothing to Disclose

Anna Rosaria Pino MD, Abstract Co-Author: Nothing to Disclose

Valentina De Marco MD, Abstract Co-Author: Nothing to Disclose

Fabrizio Mazzamurro MD, Abstract Co-Author: Nothing to Disclose

Mario Marini MD, Abstract Co-Author: Nothing to Disclose

To propose a qualitative MRI activity index for Crohn’s disease (CD)

50 patients with CD underwent ileo-colonoscopy (gold standard) and MRI, performed with T2-w and contrast-enhanced T1-w sequences, after oral administration of a superparamagnetic contrast. Endoscopic activity (CDEIS), biological activity (BA) and clinical activity (CDAI) were assessed and scored 0-3 (absent, low, definitely present, marked activity). Three qualitative activity MRI parameters, considered as predictors of activity, were similarly scored 0-3: the degree of bowel wall edema (a) and perivisceral mesenteric edema or fluid (b) on T2-w images; degree of Gd-enhancement (c). Two additional morphologic quantitative parameters were assessed: presence and number (0, 1-3, <3) of inflamed lymph nodes on T1-T2 w images (d), bowel wall thickening between 4-6 mm, 7-10 mm, > 10 mm (e). These 5 parameters produced a basic activity score ranging between 0-15: 0-2 suggesting inactivity (0); 3-5 low activity (1); 6-12 activity (2), 13-15 high activity (3). This score was correlated (Spearman correlation test) with CDEIS, BA and CDAI. The basic score (A) was further multiplied for a factor 1.5 or 2 according to the length of the affected segment (disease length > 30 cm or > 50 cm), obtaining a length-activity score (B); then for a factor 1.5 to 2 in presence of fistulas or abscesses and/or perianal disease, in relation to their extent and severity, thus providing a complication-activity score (C). A final integrated MRI score (D) ranged 0-60.

a significant correlation was obtained MRI basic score and CDAI (r=0.75), CDEIS (r= 0.87) and BA (r=0.74) with p values <0.0001. A high correlation (r=0.89 , p<0.0001) was obtained between complication-activity score and BA. Good correlation was obtained between length activity score and CDEIS (r=0.80). 

The basic MRI activity index including both T1 and T2- w activity-related parameters, as well morphologic ones, correlated with the clinical and endoscopic indexes activity. Future studies should evaluate the impact of MRI activity indexes in the clinical management of the disease.

Future studies should evaluate the importance of MRI activity indexes in the clinical management of Crohn's disease

Maccioni, F, Alansari, N, Pino, A, De Marco, V, Mazzamurro, F, Marini, M, Proposal of an MRI Activity Index for Crohns Disease.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012545.html