Background Ileocolonoscopy with histology has been considered the gold standard for Crohn disease (CD) diagnosis and monitoring. Over the last years, magnetic resonance enterography (MRE) has become more and more popular, representing a valid non-invasive technique. Objective To propose a simplified MRE score, the pediatric CD magnetic resonance index (PCDMRI), based only on the most affected bowel segment, to grade active inflammation in children with CD. Materials and methods Two radiologists retrospectively evaluated MRE images of children with histopathology-proven CD. The PCDMRI was based on six mural and perimural variables assessed for the most affected bowel segment (chosen by visual inspection of the key bowel wall imaging findings associated with active inflammation), and five extramural per- examination features. Correlation analysis was performed between both the PCDMRI and the MRE global score (based on all the affected segments) and the pediatric clinical disease activity index (PCDAI), the simple endoscopic score for CD (SES-CD), serum C-reactive protein (CRP) and fecal calprotectin (fC). Inter-reader reproducibility of the scoring system was estimated. Agreement on disease location between MRE and ileocolonoscopy was evaluated. Results The study involved 42 children for a total of 80 MRE. PCDMRI and global score positively correlated with PCDAI, SES-CD, CRP and fC. Inter-reader reproducibility was 91%. Agreement on disease location was substantial. Conclusion The PCDMRI and the global score resulted equally correlated with the PCDAI, suggesting a high impact of the most affected segment on symptoms. The PDCMRI ma

MR enterography grading of pediatric ileocolonic Crohn disease activity based on a single bowel segment / M. Napolitano, A.M. Munari, G. Di Leo, N.A.R. Panarisi, G. Zuin, G. Fava, M. Vecchi, F. Sardanelli, G.V. Zuccotti. - In: LA RADIOLOGIA MEDICA. - ISSN 0033-8362. - (2021), pp. 1-11. [Epub ahead of print] [10.1007/s11547-021-01409-w]

MR enterography grading of pediatric ileocolonic Crohn disease activity based on a single bowel segment

Napolitano, Marcello;Munari, Alice Marianna;Panarisi, Nicol Antonina Rita;Sardanelli, Francesco;Zuccotti, Gian Vincenzo
2021

Abstract

Background Ileocolonoscopy with histology has been considered the gold standard for Crohn disease (CD) diagnosis and monitoring. Over the last years, magnetic resonance enterography (MRE) has become more and more popular, representing a valid non-invasive technique. Objective To propose a simplified MRE score, the pediatric CD magnetic resonance index (PCDMRI), based only on the most affected bowel segment, to grade active inflammation in children with CD. Materials and methods Two radiologists retrospectively evaluated MRE images of children with histopathology-proven CD. The PCDMRI was based on six mural and perimural variables assessed for the most affected bowel segment (chosen by visual inspection of the key bowel wall imaging findings associated with active inflammation), and five extramural per- examination features. Correlation analysis was performed between both the PCDMRI and the MRE global score (based on all the affected segments) and the pediatric clinical disease activity index (PCDAI), the simple endoscopic score for CD (SES-CD), serum C-reactive protein (CRP) and fecal calprotectin (fC). Inter-reader reproducibility of the scoring system was estimated. Agreement on disease location between MRE and ileocolonoscopy was evaluated. Results The study involved 42 children for a total of 80 MRE. PCDMRI and global score positively correlated with PCDAI, SES-CD, CRP and fC. Inter-reader reproducibility was 91%. Agreement on disease location was substantial. Conclusion The PCDMRI and the global score resulted equally correlated with the PCDAI, suggesting a high impact of the most affected segment on symptoms. The PDCMRI ma
Crohn disease; Disease activity; MRE; Magnetic resonance enterography; Pediatric inflammatory bowel disease
Settore MED/36 - Diagnostica per Immagini e Radioterapia
Settore MED/38 - Pediatria Generale e Specialistica
Settore MED/12 - Gastroenterologia
19-ago-2021
LA RADIOLOGIA MEDICA
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/863594
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