MRI evaluation of inflammatory activity in Crohn's disease.
OBJECTIVE
We wanted to assess the capability of MRI to quantitatively evaluate the therapeutic response to Crohn's disease (CD) relapse.


METHODS
Twenty patients with histologically proven CD were prospectively evaluated with MRI and ileocolonoscopy over a 2-year period. The MRI protocol included axial and coronal T2-weighted and contrast-enhanced T1-weighted sequences. MRI examinations were performed twice, once during an acute relapse of CD and the other at clinical remission. The terminal ileum and colon were divided into six segments/patient, and the endoscopy and histology findings were considered the standard of reference. These were compared on a segmental basis with the quantitative MRI findings regarding wall thickness and contrast enhancement. The results obtained in active and remission CD phases were likewise compared with the findings in 10 control subjects who underwent complete ileocolonoscopy for other reasons and had no pathological findings on ileocolonoscopy.


RESULTS
Fifty three of 120 (44.2%) bowel segments showed pathologic changes on endoscopy and histology consistent with CD in active phase. On changing from the active disease phase to clinical remission, a significant decrease was observed in the wall thickness and contrast enhancement of the affected bowel wall. In the active phase of CD, the pathologic bowel segments presented with significantly greater contrast enhancement and wall thickness values compared with the healthy segments of CD and controls. On converting clinically into remission, contrast enhancement tended to normalize, whereas bowel wall thickness remained increased compared with the controls.


CONCLUSIONS
MRI is able to detect pathologic bowel segments in CD, as it allows the measurement of significant variations in wall thickness and contrast enhancement on changing from the active phase of the disease to remission.
Sempere
G A Javier
GA
Servicio Patologia Digestiva, Hospital General Universitario de Valencia, Valencia, Spain.
Martinez Sanjuan
Vicente
V
Medina Chulia
Enrique
E
Benages
Adolfo
A
Tome Toyosato
Alicia
A
Canelles
Pilar
P
Bulto
Antonio
A
Quiles
Francisco
F
Puchades
Iciar
I
Cuquerella
Jaime
J
Celma
Julian
J
Orti
Elisa
E
D000328:Adult; D016022:Case-Control Studies; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007082:Ileum / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors
D003287:Contrast Media; D019786:Gadolinium DTPA