Preoperative assessment of skeletal muscle mass during magnetic resonance enterography in patients with Crohn’s disease

Celentano, Valerio; Kamil-Mustafa, L.; Beable, Richard; Ball, Christopher; Flashman, Karen; Jennings, Zoe; Leary, D. P. O; Higginson, Antony; Luxton, S.

doi:10.1007/s13304-020-00790-x

Cited by 13 publications

(21 citation statements)

References 48 publications

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“…Table 1 shows the evaluation methods and frequency of sarcopenia reported in recent years in patients with IBD [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. In more than half of the reports, computed tomography (CT, L3 level) is used to assess sarcopenia, but many reports only use muscle mass assessment to determine sarcopenia, while a few include grip strength and walking speed in the assessment of sarcopenia [ 17 ].…”

Section: Methods and Frequency Of Sarcopenia Assessment In Patients With Ibdmentioning

confidence: 99%

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

Nishikawa

Nakamura

Miyazaki

et al. 2021

JCM

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Malnutrition is a major contributor to muscle loss and muscle dysfunction, known as sarcopenia. Malnutrition is common in patients with inflammatory bowel disease (IBD). IBD includes ulcerative colitis (UC) and Crohn’s disease (CD). The number of patients with IBD has recently been increasing. More severe malnutrition is often seen in CD compared to UC, probably due to CD affecting the main site of nutrient absorption, extensive mucosal lesions, fistulas, short bowel syndrome after resection, or obstruction of the gastrointestinal tract. A recent meta-analysis showed the high prevalence of sarcopenia in patients with IBD, and thus sarcopenia is a very important problem for IBD. Although IBD is more common in younger patients, sarcopenia can develop through a variety of mechanisms, including malnutrition, chronic inflammation, increased inflammatory status in adipose tissue, vitamin deficiency, and imbalance of the muscle–gut axis. In addition, sarcopenia has a negative impact on postoperative complications and hospital stay in patients with IBD. Appropriate intervention for sarcopenia may be important, in addition to clinical remission and endoscopic mucosal healing in patients with IBD. Much more attention will thus be paid to sarcopenia in patients with IBD. In this review, we outline IBD and sarcopenia, based on the current evidence.

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Section: Methods and Frequency Of Sarcopenia Assessment In Patients With Ibdmentioning

confidence: 99%

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

Nishikawa

Nakamura

Miyazaki

et al. 2021

JCM

View full text Add to dashboard Cite

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“…In the literature, there are only two known smaller scaled studies using different MRI sequences to assess myopenia or myosteatosis in patients with CD. Spooren et al [ 24 ] evaluated T1-weighted fat-saturated post-contrast images in 35 CD patients, while Celentano et al [ 25 ] assessed axial T2-weighted sequences in 31 CD patients. In these studies, myopenia and myosteatosis were associated with a higher rate of postoperative complications and unfavorable disease outcome, indicating potential clinical relevance for these two parameters [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Spooren et al [ 24 ] evaluated T1-weighted fat-saturated post-contrast images in 35 CD patients, while Celentano et al [ 25 ] assessed axial T2-weighted sequences in 31 CD patients. In these studies, myopenia and myosteatosis were associated with a higher rate of postoperative complications and unfavorable disease outcome, indicating potential clinical relevance for these two parameters [ 24 , 25 ]. In our cohort of 223 CD patients, we investigated the role of MRI-defined myopenia and myosteatosis with anastomotic leakage, postoperative complications, and recurrence rates based on a homogeneous cohort, including only patients with Crohn’s disease undergone ileocecal resection.…”

Section: Discussionmentioning

confidence: 99%

“…Myopenia, defined as the presence of clinically relevant muscle wasting due to any illness and at any age [19], and myosteatosis, the infiltration of fat in skeletal muscle, have been proposed to be prognostic factors of relevant clinical and socio-economic negative outcomes, such as poor surgical outcomes and survival rates for cancer patients [20][21][22][23]. However, their exact role in CD is unknown, since only limited data exists showing that myopenia and myosteatosis in CD patients were associated with a higher rate of postoperative complications and unfavorable disease outcome [24,25]. The aim of the present study was to assess the impact of MRI defined myopenia and myosteatosis on anastomotic leakage after ileocecal resection in patients with CD based on data of a high-volume center.…”

Section: Introductionmentioning

confidence: 99%

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Impact of myopenia and myosteatosis on postoperative outcome and recurrence in Crohn’s disease

Pozios

Kaufmann

Boubaris

et al. 2022

Int J Colorectal Dis

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Purpose Myopenia and myosteatosis have been proposed to be prognostic factors of surgical outcomes for various diseases, but their exact role in Crohn’s disease (CD) is unknown. The aim of this study is to evaluate their impact on anastomotic leakage, CD recurrence, and postoperative complications after ileocecal resection in patients with CD. Methods A retrospective analysis of CD patients undergoing ileocecal resection at our tertiary referral center was performed. To assess myopenia, skeletal muscle index (skeletal muscle area normalized for body height) was measured using an established image analysis method at third lumbar vertebra level on MRI cross-sectional images. Muscle signal intensity was measured to assess myosteatosis index. Results A total of 347 patients were retrospectively analyzed. An adequate abdominal MRI scan within 12 months prior to surgery was available for 223 patients with median follow-up time of 48.8 months (IQR: 20.0–82.9). Anastomotic leakage rate was not associated with myopenia (SMI: p = 0.363) or myosteatosis index (p = 0.821). Patients with Crohn’s recurrence had a significantly lower SMI (p = 0.047) in univariable analysis, but SMI was not an independent factor for recurrent anastomotic stenosis in multivariable analysis (OR 0.951, 95% CI 0.840–1.078; p = 0.434). Postoperative complications were not associated with myopenia or myosteatosis. Conclusion Based on the largest cohort of its kind with a long follow-up time, we could provide some data that MRI parameters for myopenia and myosteatosis may not be reliable predictors of postoperative outcome or recurrence in patients with Crohn’s disease undergoing ileocecal resection.

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“…In the literature, there are only two known smaller scaled studies using different MRI sequences to assess myopenia or myosteatosis in patients with CD. Spooren et al [24] evaluated T1-weighted fatsaturated post-contrast images in 35 CD patients, while Celentano et al [25] assessed axial T2-weighted sequences in 31 CD patients. In these studies, myopenia and myosteatosis were associated with a higher rate of postoperative complications and unfavorable disease outcome, indicating potential clinical relevance for these two parameters [24,25].…”

Section: Discussionmentioning

confidence: 99%

Impact of myopenia and myosteatosis on postoperative outcome and recurrence in Crohn’s disease

Pozios

Kaufmann

Beyer

et al. 2021

Viszeralmedizin 2021 Gemeinsame Jahrestagung Deutsche Gesellschaft Für Gastroenterologie, Verdauungs- Und Stoffwechselkrankheit

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Purpose Myopenia and myosteatosis have been proposed to be prognostic factors of surgical outcomes for various diseases, but their exact role in Crohn's disease (CD) is unknown. The aim of this study is to evaluate their impact on anastomotic leakage, CD recurrence, and postoperative complications after ileocecal resection in patients with CD. Methods A retrospective analysis of CD patients undergoing ileocecal resection at our tertiary referral center was performed. To assess myopenia, skeletal muscle index (skeletal muscle area normalized for body height) was measured using an established image analysis method at third lumbar vertebra level on MRI cross-sectional images. Muscle signal intensity was measured to assess myosteatosis index. Results A total of 347 patients were retrospectively analyzed. An adequate abdominal MRI scan within 12 months prior to surgery was available for 223 patients with median follow-up time of 48.8 months (IQR: 20.0-82.9). Anastomotic leakage rate was not associated with myopenia (SMI: p = 0.363) or myosteatosis index (p = 0.821). Patients with Crohn's recurrence had a significantly lower SMI (p = 0.047) in univariable analysis, but SMI was not an independent factor for recurrent anastomotic stenosis in multivariable analysis (OR 0.951, 95% CI 0.840-1.078; p = 0.434). Postoperative complications were not associated with myopenia or myosteatosis. Conclusion Based on the largest cohort of its kind with a long follow-up time, we could provide some data that MRI parameters for myopenia and myosteatosis may not be reliable predictors of postoperative outcome or recurrence in patients with Crohn's disease undergoing ileocecal resection.

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Preoperative assessment of skeletal muscle mass during magnetic resonance enterography in patients with Crohn’s disease

Cited by 13 publications

References 48 publications

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

Impact of myopenia and myosteatosis on postoperative outcome and recurrence in Crohn’s disease

Impact of myopenia and myosteatosis on postoperative outcome and recurrence in Crohn’s disease

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