title: Derivation of a T2-weighted MRI total colonic inflammation score (TCIS) for assessment of patients with severe acute inflammatory colitis-a preliminary study.
abstract: OBJECTIVE
  To derive an MRI score for assessing severity, therapeutic response and prognosis in acute severe inflammatory colitis.
  
  
  METHODS
  Twenty-one patients with acute severe colitis underwent colonic MRI after admission and again (n = 16) after median 5 days of treatment. Using T2-weighted images, two radiologists in consensus graded segmental haustral loss, mesenteric and mural oedema, mural thickness, and small bowel and colonic dilatation producing a total colonic inflammatory score (TCIS, range 6-95). Pre- and post-treatment TCIS were compared, and correlated with CRP, stool frequency, and number of inpatient days (therapeutic response marker). Questionnaire assessment of patient worry, satisfaction and discomfort graded 1 (bad) to 7 (good) was administered
  
  
  RESULTS
  Admission TCIS correlated significantly with CRP (Kendall's tau=0.45, 95% confidence interval [CI] 0.11-0.79, p = 0.006), and stool frequency (Kendall's tau 0.39, 95% CI 0.14-0.64, p = 0.02). TCIS fell after treatment (median [22 range 15-31]) to median 20 [range 8-25], p = 0.01. Admission TCIS but not CRP or stool frequency was correlated with length of inpatient stay (Kendall's tau 0.40, 95% CI 0.11-0.69, p = 0.02). Patients reported some discomfort (median score 4) during MRI.
  
  
  CONCLUSIONS
  MRI TCIS falls after therapy, correlates with existing markers of disease severity, and in comparison may better predict therapeutic response.
authors.affiliation: Department of Surgery, University College London Hospitals NHS Trust, London, UK.
authors.forename: Rehana
authors.initials: R
authors.lastname: Hafeez
authors.forename: Shonit
authors.initials: S
authors.lastname: Punwani
authors.forename: Doug
authors.initials: D
authors.lastname: Pendse
authors.forename: Paul
authors.initials: P
authors.lastname: Boulos
authors.forename: Stuart
authors.initials: S
authors.lastname: Bloom
authors.forename: Steve
authors.initials: S
authors.lastname: Halligan
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Taylor
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D003092:Colitis / Q000175:diagnosis*; D003106:Colon / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
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