Evaluation of Crohn disease activity with magnetic resonance imaging

Maccioni, Francesca; Broglia, Laura; Marrollo, M.; Masciangelo, Raffaele; Caprilli, R.; Rossi, Plinio

doi:10.1007/s002610000004

Cited by 270 publications

(145 citation statements)

References 32 publications

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“…Maccioni et al [33] reported a significant correlation between MR signs of intestinal inflammation (oedema in the perienteric fat, wall thickening, contrast enhancement) with a biological activity score which included white blood cells, orosomucoid levels and CRP in 20 CD patients. These results were not confirmed by other authors [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

Cappello

Tudisca

et al. 2014

Radiol med

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Purpose Few studies have correlated computed tomography enterography (CTE) findings with Crohn's disease (CD) clinical and biochemical activity. The aim of this study was to evaluate correlations between CTE findings with CD activity. Materials and methods The CTE datasets from 62 patients were retrospectively reviewed for different parameters: bowel wall thickening and hyperenhancement, mesenteric alterations, abdominal free fluid and complications related to the disease (fistulas, strictures, abscesses). Activity was assessed using the Crohn's Disease Activity Index (CDAI) and some biochemical markers (Creactive protein, erythrocyte sedimentation rate, alpha 2-globulins, fibrinogen, platelets, haemoglobin). Correlations between CTE parameters, clinical activity score and laboratory parameters were assessed by logistic regression. Results CDAI was significantly correlated with increased fat density (p = 0.03) and intestinal strictures (p = 0.04). Platelet counts were elevated in patients with enlarged mesenteric lymph nodes (p = 0.009) and the comb sign (p = 0.05). Serum alpha 2-globulins were higher in the presence of the comb sign (p = 0.03). Conclusion The CTE finding of perienteric inflammation (increased fat density) and vascular engorgement of the vasa recta in CD patients suggest that the disease is clinically active and that these patients may require more aggressive treatment than patients without these findings.

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Section: Discussionmentioning

confidence: 99%

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

Cappello

Tudisca

et al. 2014

Radiol med

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“…In der Submukosa kommt es zu Fettgewebseinlagerungen, was zu einer Schichtung in den T2-gewichteten Sequenzen führt. Fettunterdrückte Sequenzen füh-ren zu einer Signalminderung und damit zu einer Differenzierung zu einem akuten Ödem [14,16]. Befunde bei Colitis ulcerosa…”

Section: Reparativer/regenerativer Subtypunclassified

Radiologische Charakterisierung chronisch-entzündlicher Darmerkrankungen

Schöllnast

2018

Radiologe

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“…Like CT enterography, MRE involves the use of an oral contrast medium to distend the intestinal loops. Unlike CTE, it also requires the administration of drugs like butylbromide that reduce intestinal peristalsis, a source of motion artifacts that can diminish image quality [56].…”

Section: Magnetic Resonancementioning

confidence: 99%

Surgery and diagnostic imaging in abdominal Crohn’s disease

et al. 2013

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Surgery is well-established option for the treatment of Crohn's disease that is refractory to medical therapy and for complications of the disease, including strictures, fistulas, abscesses, bleeding that cannot be controlled endoscopically, and neoplastic degeneration. For a condition like Crohn's disease, where medical management is the rule, other indications for surgery are considered controversial, because the therapeutic effects of surgery are limited to the resolution of complications and the rate of recurrence is high, especially at sites of the surgical anastomosis. In the authors' opinion, however, surgery should not be considered a last-resort treatment: in a variety of situations, it should be regarded as an appropriate solution for managing this disease. Based on a review of the literature and their own experience, the authors examine some of the possibilities for surgical interventions in Crohn's disease and the roles played in these cases by diagnostic imaging modalities.Riassunto La chirurgia è un'opzione terapeutica consolidata per il trattamento della malattia di Crohn refrattaria alla terapia medica e per le complicanze legate a tale patologia quali stenosi, fistole, ascessi, sanguinamento non trattabile endoscopicamente, oltre che per i casi di degenerazione neoplastica. Per condizioni come la malattia di Crohn nelle quali il trattamento medico ha un ruolo primario, altre indicazioni per la chirurgia sono controverse, poiché i suoi effetti terapeutici sono limitati alla risoluzione delle complicanze, e la frequenza di recidive è alta, soprattutto a livello dell'anastomosi. Secondo l'opinione degli autori, tuttavia, la chirurgia non deve essere considerata come ultima opzione di trattamento: in diverse situazioni dovrebbe essere ritenuta come una soluzione adeguata nel trattamento multidisciplinare della patologia. Basandosi sulla revisione della letteratura corrente e sulla propria esperienza, gli autori hanno esaminato alcune possibilità di intervento chirurgico nella malattia di Crohn ed il ruolo che svolgono in queste condizioni le tecniche di imaging.

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Evaluation of Crohn disease activity with magnetic resonance imaging

Cited by 270 publications

References 32 publications

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

Radiologische Charakterisierung chronisch-entzündlicher Darmerkrankungen

Surgery and diagnostic imaging in abdominal Crohn’s disease

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