TY - JOUR
T1 - Crohn's disease activity before and after medical therapy evaluated by MaRIA score and others parameters in MR Enterography.
AU - Minordi, Laura Maria
AU - Larosa, Luigi
AU - Belmonte, Gianfranco
AU - Scaldaferri, Franco
AU - Poscia, Andrea
AU - Gasbarrini, Antonio
AU - Manfredi, Riccardo
PY - 2020
Y1 - 2020
N2 - AIM:
Aim of this retrospective study is to evaluate the response to therapy in Crohn's disease (CD) patients studied by MR Enterography (MRE) in comparison with Harvey Bradshaw Index (HBI).
METHODS:
One hundred and sixty patients with histological proved CD have undergone MRE in the last years. Forty-six patients who repeated MRE after medical therapy within six months were selected for the study. Magnetic Resonance Index of Activity (MaRIA) was evaluated for each patient and used to define the MR judgment. In MRE we also evaluated wall thickening, longitudinal extension of wall thickening, presence of stratified mural hyperenhancement and extraintestinal signs. The clinical response to therapy was judged based on HBI and classified as improved, worsened or stable disease. Clinical judgment was correlated with MRE findings and the agreement was analysed using the Cohen Kappa test.
RESULTS:
Among 46 enrolled patients, 18 (39%) improved clinically, 4 (10%) worsened, 24 (51%) remained stable. MR judgment was in agreement with clinical assessment in 33 patients (72%), showing moderate significant concordance (Kappa = 0.49; p < 0.01). No agreement was observed in 13 (28%) patients. Moreover, clinical improvement was significantly correlated to reduction of wall thickening, reduction of longitudinal extension of the disease and reduction of engorged vasa recta (p < 0.05). Worsening conditions were significantly correlated to increased wall thickening (p = 0.05).
CONCLUSIONS:
MRE is useful in evaluating the response to therapy in CD patients.
AB - AIM:
Aim of this retrospective study is to evaluate the response to therapy in Crohn's disease (CD) patients studied by MR Enterography (MRE) in comparison with Harvey Bradshaw Index (HBI).
METHODS:
One hundred and sixty patients with histological proved CD have undergone MRE in the last years. Forty-six patients who repeated MRE after medical therapy within six months were selected for the study. Magnetic Resonance Index of Activity (MaRIA) was evaluated for each patient and used to define the MR judgment. In MRE we also evaluated wall thickening, longitudinal extension of wall thickening, presence of stratified mural hyperenhancement and extraintestinal signs. The clinical response to therapy was judged based on HBI and classified as improved, worsened or stable disease. Clinical judgment was correlated with MRE findings and the agreement was analysed using the Cohen Kappa test.
RESULTS:
Among 46 enrolled patients, 18 (39%) improved clinically, 4 (10%) worsened, 24 (51%) remained stable. MR judgment was in agreement with clinical assessment in 33 patients (72%), showing moderate significant concordance (Kappa = 0.49; p < 0.01). No agreement was observed in 13 (28%) patients. Moreover, clinical improvement was significantly correlated to reduction of wall thickening, reduction of longitudinal extension of the disease and reduction of engorged vasa recta (p < 0.05). Worsening conditions were significantly correlated to increased wall thickening (p = 0.05).
CONCLUSIONS:
MRE is useful in evaluating the response to therapy in CD patients.
KW - Diagnostic imaging
KW - Diagnostic imaging
UR - http://hdl.handle.net/10807/150649
U2 - 10.1016/j.clinimag.2020.01.020
DO - 10.1016/j.clinimag.2020.01.020
M3 - Article
SN - 0899-7071
SP - 1
EP - 9
JO - Clinical Imaging
JF - Clinical Imaging
ER -