MR enterography: Still complementary to SES-CD for evaluation of ileal Crohn’s disease

Kocaman, Orhan

doi:10.5152/tjg.2014.0023

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…In our study we found that an ADC cut-off of 1.47 × 10 –3 mm 2 /s yielded a moderate diagnostic accuracy (72%). However, establishing a precise cut-off value may be challenging due to following reasons: (i) poor reproducibility among different scanners [46172932], (ii) complexity of ADC measurement from thin walls, particularly in the presence of peristaltic artifacts [41718], and (iii) overestimation of ADC in normally thin bowel walls or in walls thinned by fibrosis. In addition, selection of higher b values minimizes the perfusion effect of DWI, which should also be considered in interpreting ADC values [173233].…”

Section: Discussionmentioning

confidence: 99%

Can MR Enterography and Diffusion-Weighted Imaging Predict Disease Activity Assessed by Simple Endoscopic Score for Crohn’s Disease?

Soydan

Demır

Özer

et al. 2019

Journal of the Belgian Society of Radiology

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Purpose:Monitoring Crohn’s disease (CD) activity has a crucial importance, especially for evaluating treatment efficacy. Magnetic resonance enterography (MRE) and diffusion-weighted imaging (DWI) or their combination may represent potential non-invasive tools for this purpose. This study aimed to examine DWI and MRE for their potential to differentiate between different grades of ileocolonic CD activity.Materials and Methods:This retrospective study included 54 adult patients with a diagnosis of CD who underwent ileocolonoscopy and MRE including the DWI sequence. The severity of CD inflammation was categorized by Simple Endoscopic Score for Crohn’s Disease (SES-CD) as inactive, mild, moderate and severe. In addition, following conventional MRE and DWI parameters were examined: bowel wall thickness, mural T2 hyperintensity, contrast enhancement, DWI signal intensity, and apparent diffusion coefficient (ADC) values.Results:In patients with moderate to severe disease based on SES-CD, T2 hyperintensity score [1.68 ± 0.77 (1–3) vs. 2.19 ± 0.69 (1–3); p = 0.013] and mean DWI score [2.42 ± 0.58 (1–3) vs. 2.04 ± 0.69 (1–3); p = 0.037 ] were higher and mean ADC values [1.5 ± 0.4 (0.9–2.5) vs. 1.2 ± 0.3 (0.6–1.8)] were lower compared to patients with inactive to mild CD. ADC had a moderate diagnostic accuracy in predicting moderate to severe disease (AUC = 0.729, 95% CI = 0.591–0.841, p = 0.001), with a cut-off value of ≤1.47 × 10–3 mm2/sec yielded 88.5% (23/26) sensitivity, 57.1% (16/28) specificity.Conclusion:DWI, ADC and T2 signal appear to differentiate moderate to severe CD from inactive to mildly active CD, based on SES-CD evaluation and may be useful in monitoring disease activity, particularly when evaluating treatment response.

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Section: Discussionmentioning

confidence: 99%

Can MR Enterography and Diffusion-Weighted Imaging Predict Disease Activity Assessed by Simple Endoscopic Score for Crohn’s Disease?

Soydan

Demır

Özer

et al. 2019

Journal of the Belgian Society of Radiology

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“…This variation is largely attributed to the existence of cutoff values defining CD severity and response to therapy. [ 9 10 ]…”

Section: Strengths and Weaknesses Of Ses-cdmentioning

confidence: 99%

“…[ 20 ] MRE cannot be used alone, and it is rather a complementary technique to endoscopy, especially valuable for patients with extraluminal disease. [ 10 35 ] Of interest, SES-CD was also linked to anxiety prior to endoscopy and to a higher GI-specific anxiety. [ 17 ]…”

Section: Ses-cd Correlations With Fecal Serum Radiologic and Othermentioning

confidence: 99%

Implementation of the simple endoscopic activity score in crohn's disease

Koutroumpakis

Κατσάνος

2016

Saudi J Gastroenterol

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Simple Endoscopic Score for Crohn's Disease (SES-CD) was developed as an attempt to simplify Crohn's Disease Endoscopic Index of Severity (CDEIS). Since it was constructed from CDEIS, SES-CD performs comparably but also carries similar limitations. Several studies have utilized SES-CD scoring to describe disease severity or response to therapy. Some of them used SES-CD score as a continuous variable while others utilized certain cutoff values to define severity grades. All SES-CD cutoff values reported in published clinical trials were empirically selected by experts. Although in most of the studies that used SEC-CD scoring to define disease severity, a score <3 reflected inactive disease, no study is using score 0 to predefine inactivity. Studies applying SES-CD to define response to treatment used score 0. There is no optimal SES-CD cut-off for endoscopic remission. The quantification of mucosal healing using SES-CD scoring has not been standardized yet. As the definition of mucosal healing by SES-CD is unset, the concept of deep remission is also still evolving. Serum and fecal biomarkers as well as new radiologic imaging techniques are complementary to SES-CD. Current practice as well as important changes in endoscopy should be taken into consideration when defining SES-CD cutoffs. The optimal timing of SES-CD scoring to assess mucosal healing is not defined yet. To conclude, SES-CD represents a valuable tool. However, a consensus agreement on its optimal use is required.

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Rectal linitis plastica as the first presentation of metastatic lobular breast cancer: an endoscopic ultrasound diagnosis

Mazza

Laurenza

Elvo

et al. 2022

Clin J Gastroenterol

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MR enterography: Still complementary to SES-CD for evaluation of ileal Crohn’s disease

Cited by 4 publications

References 7 publications

Can MR Enterography and Diffusion-Weighted Imaging Predict Disease Activity Assessed by Simple Endoscopic Score for Crohn’s Disease?

Can MR Enterography and Diffusion-Weighted Imaging Predict Disease Activity Assessed by Simple Endoscopic Score for Crohn’s Disease?

Implementation of the simple endoscopic activity score in crohn's disease

Rectal linitis plastica as the first presentation of metastatic lobular breast cancer: an endoscopic ultrasound diagnosis

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