title: Differences in the location and activity of intestinal Crohn's disease lesions between adult and paediatric patients detected with MRI.
abstract: OBJECTIVE
  To prospectively compare paediatric patients (PP) and adult patients (AP) affected by Crohn's disease (CD) in terms of the location and activity of intestinal lesions.
  
  
  METHODS
  Forty-three children (mean age 15 years) and 43 adults (mean age 48 years) with proven CD underwent magnetic resonance enterography (MRE) to localise lesions and detect their activity in 9 segments of the small and large bowel. The results were analysed on a per patient and per segment basis. Ileo-colonoscopy was performed in all patients. P values less than 0.05 were considered statistically significant.
  
  
  RESULTS
  Involvement of terminal ileum was significantly different in the two groups: observed in 100 % of AP (43/43) versus 58 % (23/43) of PP (P < 0.0001). Conversely, the colon was diseased in 84 % of PP versus 64 % of AP. In particular, left colonic segments were significantly more involved in PP (descending colon 53 % versus 21 %, P < 0.01; rectum 67 % versus 23 %, P < 0.0001; sigmoid colon 56 % versus 37 %, not significant), whereas caecal involvement was equal in both groups. In children the maximal disease activity was found in left colonic segments, whereas in adults it was in the terminal ileum.
  
  
  CONCLUSIONS
  MRE detected significant differences between the two populations, showing a more extensive and severe involvement of the left colon in children but the distal ileum in adults.
  
  
  CONCLUSIONS
  • MRI is useful for assessing Crohn's disease in adult and paediatric patients.                                  • Adult and paediatric patients show different intestinal involvement on MRI.                                  • The distal ileum is maximally involved in adults vs. the left colon in children.                 • The causes of the severe left colonic disease in children are unknown.                                  • The extensive colonic involvement in children has clinical-diagnostic implications.
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University, Viale Regina Elena 324, 00161, Rome, Italy. francesca.maccioni@uniroma1.it
authors.forename: Francesca
authors.initials: F
authors.lastname: Maccioni
authors.forename: Franca
authors.initials: F
authors.lastname: Viola
authors.forename: Federica
authors.initials: F
authors.lastname: Carrozzo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Nardo
authors.forename: Anna Rosaria
authors.initials: AR
authors.lastname: Pino
authors.forename: Ilaria
authors.initials: I
authors.lastname: Staltari
authors.forename: Najwa
authors.initials: N
authors.lastname: Al Ansari
authors.forename: Annarita
authors.initials: A
authors.lastname: Vestri
authors.forename: Alberto
authors.initials: A
authors.lastname: Signore
authors.forename: Mario
authors.initials: M
authors.lastname: Marini
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cucchiara
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000503:physiopathology; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007082:Ileum / Q000503:physiopathology; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results