title: Accuracy of Diffusion-weighted Magnetic Resonance Colonography in Assessing Mucosal Healing and the Treatment Response in Patients with Ulcerative Colitis.
abstract: OBJECTIVE
  Using sigmoidoscopy as the gold standard, we assessed the accuracy, and the responsiveness to change, of diffusion-weighted magnetic resonance colonography in ulcerative colitis, using the Nancy score.
  
  
  METHODS
  A total of 29 ulcerative colitis patients, having undergone at least two diffusion-weighted magnetic resonance colonographies, were included. Disease activity was evaluated using the Mayo endoscopic subscore and the Nancy score. We determined the accuracy of the Nancy score in the diagnosis of mucosal healing. We also assessed its responsiveness to change in 17 patients with a Mayo endoscopic subscore of 2 or 3 at treatment initiation.
  
  
  RESULTS
  A total Nancy score < 7 had a sensitivity of 0.75 and a specificity of 0.67 (area under the curve: 0.72; 95% confidence interval: [0.56-0.88]; p = 0.0063) in the diagnosis of mucosal healing. The total Nancy score was sensitive to change in ulcerative colitis [Guyatt's responsiveness index: 1.8; standardised effect size ratio: 1.36]. The Nancy score was reliable [intra-class correlation coefficient: 0.63; p = 0.01]. The mean Mayo endoscopic subscore and the mean Nancy score both fell significantly in patients who achieved mucosal healing (mean ± standard deviation [SD] Mayo endoscopic subscore: 2.4 ± 0.55 at baseline and 0.6 ± 0.55 at reassessment, p = 0.02; mean Nancy score: 18.2 ± 9.1 at baseline and 3 ± 1.6 at reassessment, p = 0.006). No significant changes in Nancy score were observed in active patients at reassessment.
  
  
  CONCLUSIONS
  The Nancy score is a highly responsive, reliable tool for assessing treatment response in patients with ulcerative colitis. The Nancy score accurately detects mucosal healing.
authors.affiliation: Department of Radiology, Nancy University Hospital, Nancy, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Laurent
authors.affiliation: INSERM U954 and Department of Hepatogastroenterology, Nancy University Hospital, Lorraine University, Nancy, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Naudé
authors.affiliation: Department of Radiology, Nancy University Hospital, Nancy, France.|Department of Gastroenterology, Besançon University Hospital, Besançon, France.
authors.forename: Lucine
authors.initials: L
authors.lastname: Vuitton
authors.affiliation: Department of Radiology, Nancy University Hospital, Nancy, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Zallot
authors.affiliation: ESPRI-BioBase Unit, PARC Clinical Research Support Facility, Nancy University Hospital, Nancy, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Baumann
authors.affiliation: INSERM U954 and Department of Hepatogastroenterology, Nancy University Hospital, Lorraine University, Nancy, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Girard-Gavanier
authors.affiliation: Department of Radiology, Nancy University Hospital, Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
mesh_terms: D000328:Adult; D019540:Area Under Curve; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D003106:Colon / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012812:Sigmoidoscopy; D016896:Treatment Outcome; D014945:Wound Healing
keywords: MRI; Ulcerative colitis; mucosal healing