scholarly journals Monitoring Crohn’s disease activity: endoscopy, fecal markers and computed tomography enterography

2018 ◽  
Vol 11 ◽  
pp. 175628481876907 ◽  
Author(s):  
Susana Lopes ◽  
Patrícia Andrade ◽  
Joana Afonso ◽  
Rui Cunha ◽  
Eduardo Rodrigues-Pinto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Rank Correlation ◽  
Response To Therapy ◽  
Newly Diagnosed ◽  
Mesenteric Fat ◽  
Computed Tomography Enterography

Background: The treatment goal of Crohn’s disease (CD) has moved towards achieving mucosal healing, resolution of transmural inflammation, and normalization of biomarkers. The purpose of this study was to evaluate how well computed tomography enterography (CTE) and fecal calprotectin (FC) correlated with endoscopic activity in newly diagnosed patients with CD and after 1 year of therapy. Methods: Consecutive patients with newly diagnosed CD were evaluated by endoscopy, CTE, and FC at diagnosis and 12 months after beginning immunosuppression. Endoscopic severity was assessed using the Simplified Endoscopic Score for Crohn’s Disease (SES-CD). Biomarkers, clinical indexes, and FC were recorded on the day of ileocolonoscopy at diagnosis and 1 year after diagnosis. We adapted a CTE score for disease activity based on radiological signs of inflammation (i.e. mural thickness, mural hyperenhancement, mesenteric fat proliferation, mesenteric fat densification, comb sign, presence of strictures, fistulas, abscesses, ascites, and lymphadenopathy). Correlations between endoscopy, CTE, and FC were assessed using Spearman’s rank correlation. Results: A total of 29 patients (48% women; median age 30 (24.5–35.5) years) were included in this prospective cohort. CTE findings significantly correlated with endoscopic findings. Endoscopic remission (ER) at 1-year follow up significantly correlated with improvement in mural hyperenhancement ( p = 0.004), mesenteric fat densification ( p = 0.001), comb sign ( p = 0.004), and strictures ( p = 0.008) in CTE. None of the CTE findings improved in patients without ER. FC correlated with SES-CD ( rs = 0.696, p < 0.001) and with CTE features of inflammation ( rs = 0.596, p < 0.001). A cut-off of 100 µg/g predicted ER with 92% sensitivity, 65% specificity, and 83% accuracy (area under curve 0.878, p < 0.001). Conclusions: CTE findings and FC levels correlated with endoscopic activity in CD both at diagnosis and at 1-year follow up. These two noninvasive markers of disease activity may be used as an alternative to endoscopy to monitor disease response to therapy.

S1221 Computed Tomography Enterography and Small Bowel Ultrasound in Assessing Ileal Crohn's Disease Activity

2008 ◽  
Vol 134 (4) ◽  
pp. A-204
Author(s):  
Alessandra Losco ◽  
Chiara Trattenero ◽  
Mirella Fraquelli ◽  
Laura Virginia Forzenigo ◽  
Sara Massironi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Computed Tomography Enterography ◽  
Crohn’S Disease Activity ◽  
Bowel Ultrasound

scholarly journals Intestinal Ultrasound in Inflammatory Bowel Disease: A Valuable and Increasingly Important Tool

2021 ◽  
pp. 1-17
Author(s):  
Catarina Frias-Gomes ◽  
Joana Torres ◽  
Carolina Palmela
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Response To Therapy ◽  
Inflammatory Bowel

<b><i>Background:</i></b> Intestinal ultrasound is emerging as a non-invasive tool for monitoring disease activity in inflammatory bowel disease patients due to its low cost, excellent safety profile, and availability. Herein, we comprehensively review the role of intestinal ultrasound in the management of these patients. <b><i>Summary:</i></b> Intestinal ultrasound has a good accuracy in the diagnosis of Crohn’s disease, as well as in the assessment of disease activity, extent, and evaluating disease-related complications, namely strictures, fistulae, and abscesses. Even though not fully validated, several scores have been developed to assess disease activity using ultrasound. Importantly, intestinal ultrasound can also be used to assess response to treatment. Changes in ultrasonographic parameters are observed as early as 4 weeks after treatment initiation and persist during short- and long-term follow-up. Additionally, Crohn’s disease patients with no ultrasound improvement seem to be at a higher risk of therapy intensification, need for steroids, hospitalisation, or even surgery. Similarly to Crohn’s disease, intestinal ultrasound has a good performance in the diagnosis, activity, and disease extent assessment in ulcerative colitis patients. In fact, in patients with severe acute colitis, higher bowel wall thickness at admission is associated with the need for salvage therapy and the absence of a significant decrease in this parameter may predict the need for colectomy. Short-term data also evidence the role of intestinal ultrasound in evaluating therapy response, with ultrasound changes observed after 2 weeks of treatment and significant improvement after 12 weeks of follow-up in ulcerative colitis. <b><i>Key Messages:</i></b> Intestinal ultrasound is a valuable tool to assess disease activity and complications, and to monitor response to therapy. Even though longer prospective data are warranted, intestinal ultrasound may lead to a change in the paradigm of inflammatory bowel disease management as it can be used in a point-of-care setting, enabling earlier intervention if needed.

scholarly journals Which MRI Score and Technique Should Be Used for Assessing Crohn’s Disease Activity?

2020 ◽  
Vol 9 (6) ◽  
pp. 1691
Author(s):  
Ferdinando D’Amico ◽  
Thomas Chateau ◽  
Valérie Laurent ◽  
Silvio Danese ◽  
Laurent Peyrin-Biroulet
Keyword(s):  
Crohn’S Disease ◽  
Magnetic Resonance ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Response To Therapy ◽  
Mr Enterography ◽  
Intravenous Contrast ◽  
Diffusion Weighted Images ◽  
Disease Outcomes

Magnetic resonance (MR) enterography is assuming an increasingly important and central role in the management of patients with Crohn’s disease, as it is not only involved in diagnosis and staging of the disease but also allows for patients’ follow-up, evaluating the response to therapy, and predicting disease outcomes. Several MR scores have been developed but unfortunately there is no globally accepted score. The most widely used scores are the Magnetic Resonance Index of Activity (MaRIA) score, the London score, the Nancy score, and the Clermont score; however, there are multiple differences between these tools in terms of the assessed radiological items, fasting, administration of oral or intravenous contrast, and the use of diffusion-weighted images. Here we reviewed the main characteristics of each MR scoring system to clarify which is the most appropriate score for monitoring disease activity in both clinical practice and clinical trials.

scholarly journals Diagnostic role of computed tomography enterography (CTE) in assessment of intra-mural and extra-intestinal CT findings in active Crohn’s disease (CD)

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Rasha Mostafa Mohamed Ali ◽  
Mai Bahgat Ibrahim Ghonimy
Keyword(s):  
Computed Tomography ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Disease Process ◽  
Ct Enterography ◽  
Computed Tomography Enterography ◽  
Mucosal Thickening

Abstract Background Crohn’s disease (CD) is a ruinous bowel disease, which, if left uncured, leads to penetrating bowel complications. Computed tomography enterography (CTE) is nowadays accepted as a principal modality for the assessment of small bowel diseases. The aim of this study is to assess the role of CT enterography in the identification of intramural as well as extra-intestinal CT changes yielding more thorough data about the level and severity of the disease process thus planning appropriate treatment strategy. Results From March 2017 to January 2019, 50 patients in Cairo, Egypt, who had clinical manifestations of inflammatory bowel disease, were evaluated by MDCTE. CT image analysis was processed, including anatomical localization of bowel segments affection, assessment of mucosal thickening and hyper-enhancement, and extra-enteric affection. Diagnosis of Crohn’s disease (CD) was confirmed by endoscopy and histopathology; mucosal thickening was seen in 42 patients (84%), mucosal hyper-enhancement was seen in 44 patients (88%) while engorgement of vasa recta (comb’s sign) was seen in 38 patients (76%). Conclusion Although ileocolonoscopy is a proven sensitive method to detect mucosal injury and diagnose disease activity, it is limited by its maximal extent and inability to detect transmural complications as well as limited ability to assess deep bowel wall involvement. CT enterography (CTE) is a valuable technique in diagnostic evaluation of intramural and extra-intestinal involvement in Crohn’s disease (CD) during disease activity.

scholarly journals Computed tomography enterography in assessment of Crohn’s disease activity

2015 ◽  
Vol 51 (2) ◽  
pp. 105-110
Author(s):  
Enas Abdel Ghany Ibrahim ◽  
Leila Rawash El-Dieb ◽  
Nivine Chalabi ◽  
Noha Mohamed Osman
Keyword(s):  
Computed Tomography ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Computed Tomography Enterography ◽  
Crohn’S Disease Activity
Sign in / Sign up

Export Citation Format

Share Document