Accuracy of MRI to Assess Therapeutic Responses and Mucosal Healing in Crohn's Disease

Ordás, Íngrid; Rimola, Jordi; Ripollés, Tomás; García-Bosch, Orlando; Rodríguez, Sonia García; Ayuso, Carmen; Ricart, Elena; Paredes, José María Rubio; Panés, Julián

doi:10.1016/s0016-5085(11)60295-3

Cited by 9 publications

(4 citation statements)

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“…Ordàs et al used the MaRIA score to monitor response to therapy in 27 patients after 12 weeks of corticosteroid or adalimumab therapy (CDEIS was used as the reference standard). 73 A MaRIA score below 40 predicted endoscopic remission with a sensitivity of 82% and a specificity of 85%. Van Assche et al followed up 15 patients on infliximab therapy by performing MRI enteroclysis at weeks 2 and 26.…”

Section: Mrimentioning

confidence: 96%

“…In particular, once clinical remission had been achieved, there was no significant difference in the mean contrast enhancement between CD patients and controls, but intestinal segments remained thicker in CD patients in remission than in healthy controls. Ordàs et al used the MaRIA score to monitor response to therapy in 27 patients after 12 weeks of corticosteroid or adalimumab therapy (CDEIS was used as the reference standard) 73. A MaRIA score below 40 predicted endoscopic remission with a sensitivity of 82% and a specificity of 85%.…”

Section: Mrimentioning

confidence: 99%

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Measuring disease activity in Crohn's disease: what is currently available to the clinician

D’Incà

Caccaro

2014

CEG

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Crohn’s disease (CD) is a chronic inflammatory bowel disease characterized by a relapsing-remitting clinical behavior and dominated by intestinal inflammation. Being a chronic disorder that with time develops into a disabling disease, it is important to monitor the severity of inflammation to assess the efficacy of medication, rule out complications, and prevent progression. This is particularly true now that the goals of treatment are mucosal healing and deep remission. Endoscopy has always been the gold standard for assessing mucosal activity in CD, but its use is limited by its invasiveness and its inability to examine the small intestine, proximal to the terminal ileum. Enteroscopy and the less invasive small bowel capsule endoscopy enable the small bowel to be thoroughly explored and scores are emerging for classifying small bowel disease activity. Cross-sectional imaging techniques (ultrasound, magnetic resonance, computed tomography) are emerging as valid tools for monitoring CD patients, assessing inflammatory activity in the mucosa and the transmucosal extent of the disease, and for excluding extra-intestinal complications. Neither endoscopy nor imaging are suitable for assessing patients frequently, however. Noninvasive markers such as C-reactive protein, and fecal biomarkers such as calprotectin and lactoferrin, are therefore useful to confirm the inflammatory burden of the disease and to identify patients requiring further investigations.

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Section: Mrimentioning

confidence: 96%

Section: Mrimentioning

confidence: 99%

Measuring disease activity in Crohn's disease: what is currently available to the clinician

D’Incà

Caccaro

2014

CEG

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“…In clinical practice, IBD and especially CD are commonly evaluated by endoscopy for mucosal assessment and by magnetic resonance (MR) for transmural lesions [12] , [13] Numerous studies both in humans and animals have correlated MR images with severity of endoscopic lesions [12] , [14] , [15] , [16] , [17] . Whereas MR evaluation of inflammation is easy and becoming routine practice, assessment of fibrosing lesions is more challenging [13] .…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Colonography for Fibrosis Assessment in Rats with Chronic Colitis

et al. 2014

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BackgroundMagnetic resonance colonography (MRC) has been developed to assess inflammatory bowel diseases. We aimed to assess the feasibility of MRC in rats with TNBS-induced chronic colitis and to confront imaging results with fibrosis and stenosing features of the model.Materials and MethodsChronic colitis was induced in 12 rats by weekly intra-rectal injection of increasing doses of TNBS for 6 weeks, while 8 control rats received the vehicle. At week 7, MRC was performed. Fibrosis scores were assessed and fibrosis mediators measured.ResultsChronic colitis was associated with significant body weight loss (p<0.0001) and higher colon weight/length compared to controls (p = 0.0004). Fibrosis mediators and histological scores were significantly higher in rats with TNBS than in controls: α-SMA expression (0.9 versus 0.61, p = 0.0311) and fibrosis score (p = 0.0308). Colon wall thickness was higher in rats with TNBS than in controls: maximal thickness (2.38 versus 0.74 mm, p<0.0001) and minimal thickness (1.33 versus 0.48 mm, p<0.0001). Wall signal intensity on T2w images was higher in rats with TNBS than in controls (9040 versus 6192, p = 0.0101) and correlated with fibrosis score (r = 0.5214; p = 0.04). Luminal narrowing was higher in rats with TNBS (50.08 versus 10.33%, p<0.0001) and correlated with α-SMA expression (r = 0.5618; p = 0.01). Stenosis was observed in 7/9 rats with TNBS and in no controls (p = 0.0053).ConclusionsMRC is feasible and easily distinguishes rats with colitis from controls. MRC signs correlated with fibrosis parameters. MRC evaluation may be part of a new anti-fibrosis drug assessment in experimental models of chronic colitis.

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“…51,52 Rather, evidence suggests that deep remission (ie, full mucosal healing) should be the goal of therapy. 51,52,57 Numerous studies have demonstrated that mural and mesenteric disease may still underlie a healed mucosa on endoscopy. 54,55 Reduction in the signs of active inflammation (wall thickening, hyperenhancement, and T2 prolongation) may prove to be superior in assessing treatment response rather than clinical symptoms alone and could serve as a benchmark when developing new drugs.…”

Section: Limitations Of Mrementioning

confidence: 99%

Comprehensive Magnetic Resonance Enterography of Crohn׳s Disease in the Pediatric Population: Technique, Interpretation, and Management

Chehab

Hlubocky

Olariu

et al. 2015

Current Problems in Diagnostic Radiology

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Accuracy of MRI to Assess Therapeutic Responses and Mucosal Healing in Crohn's Disease

Cited by 9 publications

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Measuring disease activity in Crohn's disease: what is currently available to the clinician

Measuring disease activity in Crohn's disease: what is currently available to the clinician

Magnetic Resonance Colonography for Fibrosis Assessment in Rats with Chronic Colitis

Comprehensive Magnetic Resonance Enterography of Crohn׳s Disease in the Pediatric Population: Technique, Interpretation, and Management

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Accuracy of MRI to Assess Therapeutic Responses and Mucosal Healing in Crohn's Disease

Cited by 9 publications

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Measuring disease activity in Crohn&#39;s disease: what is currently available to the clinician

Measuring disease activity in Crohn&#39;s disease: what is currently available to the clinician

Magnetic Resonance Colonography for Fibrosis Assessment in Rats with Chronic Colitis

Comprehensive Magnetic Resonance Enterography of Crohn׳s Disease in the Pediatric Population: Technique, Interpretation, and Management

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Measuring disease activity in Crohn's disease: what is currently available to the clinician

Measuring disease activity in Crohn's disease: what is currently available to the clinician