title: Magnetic resonance enterography versus capsule endoscopy activity indices for quantification of small bowel inflammation in Crohn's disease.
abstract: BACKGROUND
  Video capsule endoscopy (VCE) and magnetic resonance enterography (MRE) are the prime modalities for the evaluation of small bowel (SB) Crohn's disease (CD). Mucosal inflammation on VCE is quantified using the Lewis score (LS). Diffusion-weighted (DW) magnetic resonance imaging (MRI) allows for accurate assessment of SB inflammation without administration of intravenous contrast material. The Magnetic Resonance Index of Activity (MaRiA) and the Clermont index are quantitative activity indices validated for contrast-enhanced MRE and DW-MRE, respectively. The aim of this study was to compare the quantification of distal SB inflammation by VCE and MR-related activity indices.
  
  
  METHODS
  Patients with known quiescent SB CD were prospectively recruited and underwent MRE and VCE. LS, MaRIA and Clermont scores were calculated for the distal SB.
  
  
  RESULTS
  Both MRI-based indices significantly correlated with the LS and the Clermont index (r = 0.50, p = 0.001 and r = 0.53, p = 0.001, respectively). Both MaRIA and Clermont scores were significantly lower in patients with mucosal healing (LS < 135). The area under the curve (AUC) with both MR scores was moderate for prediction of any mucosal inflammation (LS ⩾ 135) and excellent for prediction of moderate-to-severe inflammation (LS ⩾ 790) (0.71 and 0.74 versus 0.93 and 0.91 for MaRIA and Clermont score, respectively).
  
  
  CONCLUSIONS
  Modest correlation between VCE- and MRE-based quantitative indices of inflammation in patients with quiescent SB CD was observed. Between-modality correlation was higher in patients with endoscopically severe disease. DW-MRE gauged by Clermont score was at least as accurate as contrast-enhanced MRE for quantification of SB inflammation.
authors: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer 52621, Israel.
authors: Uri
authors: U
authors: Kopylov
authors: Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
authors: Eyal
authors: E
authors: Klang
authors: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
authors: Doron
authors: D
authors: Yablecovitch
authors: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
authors: Adi
authors: A
authors: Lahat
authors: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
authors: Benjamin
authors: B
authors: Avidan
authors: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
authors: Sandra
authors: S
authors: Neuman
authors: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
authors: Nina
authors: N
authors: Levhar
authors: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
authors: Tomer
authors: T
authors: Greener
authors: Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
authors: Noa
authors: N
authors: Rozendorn
authors: Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
authors: Arkadi
authors: A
authors: Beytelman
authors: IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors: Henit
authors: H
authors: Yanai
authors: IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors: Iris
authors: I
authors: Dotan
authors: Rambam Health Care Campus, Haifa, Israel.
authors: Yehuda
authors: Y
authors: Chowers
authors: Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel.
authors: Batya
authors: B
authors: Weiss
authors: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
authors: Shomron
authors: S
authors: Ben-Horin
authors: Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
authors: Marianne M
authors: MM
authors: Amitai
authors: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
authors: Rami
authors: R
authors: Eliakim
keywords: Crohn’s disease; diffusion-weighted MRI; magnetic resonance enterography; videocapsule endoscopy