title: Diffusion-weighted magnetic resonance for assessing ileal Crohn's disease activity.
abstract: BACKGROUND
  Endoscopy and imaging objectively assess Crohn's disease (CD) activity. Magnetic resonance enterography (MRE) uses no ionizing radiation, carries no significant morbidity, and is highly sensitive in revealing soft tissues inflammation. Diffusion-weighted imaging can distinguish intestinal inflammation from a lower diffusion of water molecules giving rise to a reduced apparent diffusion coefficient. The magnetic resonance index of activity score and, more recently, the Clermont score were recently developed for staging CD activity. The aim of this study was to compare the MRE scores and the Simple Endoscopic Score for CD in identifying ileal CD activity.
  
  
  METHODS
  Fifty-five patients with ileal and ileocolonic CD were consecutively enrolled between June 2012 and June 2013. All patients underwent clinical examination, biochemical tests, MRE, and colonoscopy to assess disease activity.
  
  
  RESULTS
  MRE assessed active ileal disease in 31 patients (56.3%). The Clermont score significantly correlated with the magnetic resonance index of activity score (r = 0.91; P < 0.0001) and the Simple Endoscopic Score for CD (r = 0.76; P < 0.0001). The apparent diffusion coefficient correlated with the Simple Endoscopic Score for CD (r = -0.63; P < 0.0001) especially in unoperated patients.
  
  
  CONCLUSIONS
  The Clermont score and the apparent diffusion coefficient value can stage ileal CD, avoiding the need to use contrast agents.
authors.affiliation: *Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy; †Oncological Surgery Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy; ‡Radiology I, Azienda Ospedaliera di Padova, Padova, Italy; and §Division of General Surgery, Azienda Ospedaliera di Padova, Padova, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Caruso
authors.forename: Renata
authors.initials: R
authors.lastname: DʼIncà
authors.forename: Marco
authors.initials: M
authors.lastname: Scarpa
authors.forename: Paolo
authors.initials: P
authors.lastname: Manfrin
authors.forename: Massimo
authors.initials: M
authors.lastname: Rudatis
authors.forename: Anna
authors.initials: A
authors.lastname: Pozza
authors.forename: Imerio
authors.initials: I
authors.lastname: Angriman
authors.forename: Andrea
authors.initials: A
authors.lastname: Buda
authors.forename: Giacomo Carlo
authors.initials: GC
authors.lastname: Sturniolo
authors.forename: Carmelo
authors.initials: C
authors.lastname: Lacognata
mesh_terms: D000328:Adult; D003113:Colonoscopy; D003287:Contrast Media; D003424:Crohn Disease / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007079:Ileitis / Q000175:diagnosis*; D007082:Ileum / Q000473:pathology*; D007091:Image Processing, Computer-Assisted; D007249:Inflammation / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media