title: Diagnostic accuracy of magnetic resonance colonography for the evaluation of disease activity and severity in ulcerative colitis: a prospective study.
abstract: OBJECTIVE
  The aim of this study was to determine the diagnostic accuracy of magnetic resonance colonography (MRC) for the evaluation of disease activity and severity in patients with ulcerative colitis (UC) using endoscopy as the reference standard.
  
  
  METHODS
  Fifty patients with UC underwent colonoscopy and MRC for the evaluation of disease activity. All patients were prospectively and consecutively included. Endoscopic activity was evaluated globally and on a segment basis using the modified Baron score (MBS), and also classified as absent, mild to moderate (inflammation without ulcers) or severe (presence of ulceration). MRC parameters evaluated in each segment were: wall thickness, pre- and post-contrast wall signal intensity, relative contrast enhancement (RCE), mural oedema, ulcers, enlarged lymph nodes and the comb sign.
  
  
  RESULTS
  Independent predictors for endoscopic activity on a segment basis were RCE (p=0.006), presence of oedema (p=0.003), enlarged lymph nodes (p<0.001) and the comb sign (p<0.001). A segmental simplified MRC index (MRC-S) ≥ 1 detected endoscopic inflammation with high diagnostic accuracy (sensitivity 87%, specificity 88%, area under the curve (AUC) 0.95; p<0.001). MRC-S index ≥ 2 detected severe lesions with high sensitivity (83%) and specificity (82%) with an AUC of 0.91 (p<0.001). The MRC-S index strongly correlated with the MBS (r=0.81, p<0.001) and with the subjective assessment of the radiologists for the evaluation of disease severity (r=0.77, p<0.001).
  
  
  CONCLUSIONS
  MRC has a high accuracy for the diagnosis of disease activity and severity in UC.
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Ordás
authors.forename: Jordi
authors.initials: J
authors.lastname: Rimola
authors.forename: Orlando
authors.initials: O
authors.lastname: García-Bosch
authors.forename: Sonia
authors.initials: S
authors.lastname: Rodríguez
authors.forename: Marta
authors.initials: M
authors.lastname: Gallego
authors.forename: María Josefina
authors.initials: MJ
authors.lastname: Etchevers
authors.forename: María
authors.initials: M
authors.lastname: Pellisé
authors.forename: Faust
authors.initials: F
authors.lastname: Feu
authors.forename: Begoña
authors.initials: B
authors.lastname: González-Suárez
authors.forename: Carmen
authors.initials: C
authors.lastname: Ayuso
authors.forename: Elena
authors.initials: E
authors.lastname: Ricart
authors.forename: Julián
authors.initials: J
authors.lastname: Panés
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis*; D003113:Colonoscopy / Q000379:methods; D004487:Edema / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index