title: Differentiation between active and chronic Crohn's disease using MRI small-bowel motility examinations - initial experience.
abstract: OBJECTIVE
  To evaluate the influence of locally active Crohn's disease on systemic small-bowel motility in patients with chronic Crohn's disease compared to healthy individuals.
  
  
  METHODS
  Fifteen healthy individuals (11 men, four women; mean age 37 years) and 20 patients with histopathologically proven active (n = 15; 10 women, 5 men; mean age 45 years) or chronic (n = 5; four women, one man; mean age 48 years) Crohn's disease were included in this institutional review board-approved, retrospective study. Magnetic resonance imaging (MRI; 1.5 T) was performed after standardized preparation. Two-dimensional (2D) cine sequences for motility acquisition were performed in apnoea (27 s). Motility assessment was performed using dedicated software in three randomly chosen areas of the small-bowel outside known Crohn's disease-affected hotspots. The main quantitative characteristics (frequency, amplitude, occlusion rate) were compared using Student's t-test and one-way analysis of variance (ANOVA).
  
  
  RESULTS
  Three randomly chosen segments were analysed in each participant. Patients with active Crohn's disease had significantly (p < 0.05) reduced contraction frequencies (active Crohn's disease: 2.86/min; chronic: 4.14/min; healthy: 4.53/min) and luminal occlusion rates (active: 0.43; chronic: 0.70; healthy: 0.73) compared to healthy individuals and patients with chronic Crohn's disease. Contraction amplitudes were significantly reduced during active Crohn's disease (6.71 mm) compared to healthy participants (10.14 mm), but this only reached borderline significance in comparison to chronic Crohn's disease (8.87 mm). Mean bowel lumen diameter was significantly (p = 0.04) higher in patients with active Crohn's disease (16.91 mm) compared to healthy participants (14.79 mm) but not in comparison to patients with chronic Crohn's disease (13.68).
  
  
  CONCLUSIONS
  The findings of the present study suggest that local inflammatory activity of small-bowel segments in patients with active Crohn's disease alters small-bowel motility in distant, non-affected segments. The motility patterns revealed reduced contraction-wave frequencies, amplitudes, and decreased luminal occlusion rates. Thus evaluation of these characteristics potentially helps to differentiate between chronic and active Crohn's disease.
authors: Department of Radiology, University Hospital Zürich, Zürich, Switzerland.
authors: S
authors: S
authors: Bickelhaupt
authors: J M
authors: JM
authors: Froehlich
authors: R
authors: R
authors: Cattin
authors: N
authors: N
authors: Patuto
authors: R
authors: R
authors: Tutuian
authors: K U
authors: KU
authors: Wentz
authors: J L
authors: JL
authors: Culmann
authors: S
authors: S
authors: Raible
authors: H
authors: H
authors: Bouquet
authors: U
authors: U
authors: Bill
authors: M A
authors: MA
authors: Patak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003424:Crohn Disease / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D007082:Ileum / Q000473:pathology / Q000503:physiopathology; D007421:Intestine, Small / Q000473:pathology / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult