Evaluation of Crohn’s disease activity: Initial validation of a magnetic resonance enterography global score (MEGS) against faecal calprotectin

Abstract

• Magnetic resonance imaging is now widely used to assess Crohn's disease. • Existing MRI activity scores depend on local segmental endoscopic/histological reference standards. • Scores including assessment of disease extent/complications better demonstrate full disease burden. • This new global Crohn's disease burden score correlates with calprotectin and CRP. • The MRI enterography score of disease activity can complement existing clinical markers.

Relationship between MRI quantified small bowel motility and abdominal symptoms in Crohn’s disease patients—a validation study

“…For example, the CD activity score has been developed and validated against a histological standard of reference 28 and has recently been extended to provide a global MRI activity score (MRI enterography global score). 6 However, in previous work no significant correlation was found between the MRI enterography global score and HBI (r = 0.102, p = 0.40) in a cohort of 71 patients. 6 Additionally, Makanyanga et al 6 reported no correlation between a CD activity score and HBI (r = 0.045, p = 0.630).…”

“…6 However, in previous work no significant correlation was found between the MRI enterography global score and HBI (r = 0.102, p = 0.40) in a cohort of 71 patients. 6 Additionally, Makanyanga et al 6 reported no correlation between a CD activity score and HBI (r = 0.045, p = 0.630). Indeed, HBI also correlates poorly with objective measures of inflammation such as faecal calprotectin (fCP).…”

“…6,30 It also suggests that anatomical or structural MRI observations show little correlation with patient symptoms as captured by HBI. It has been acknowledged however that we did not reconfirm this lack of association as part of the design of the current study.…”

“…4,5 For example faecal calprotectin levels and MRI features of bowel inflammation often show poor correlation with the HBI. 6 Furthermore, even when patients are in apparent endoscopic and biochemical remission, many still suffer ongoing abdominal symptoms including diarrhoea and abdominal pain with profound effects on quality of life. 4,7,8 The aetiology of abdominal symptoms and their link to disease activity therefore remains obscure.…”

Comparison of three magnetic resonance enterography indices for grading activity in Crohn’s disease

“…We did not include other indices in our analysis because of their inherent limitations such those derived based on expert opinion [15,16], or those derived using fecal calprotectin as reference standard [17] which has the caveat of a low sensitivity for detecting small bowel inflammation.…”