scholarly journals Role of Imaging in Small Bowel Crohn’s Disease

2021 ◽  
Author(s):  
Bilal Imširović ◽  
Enver Zerem ◽  
Emir Gušo
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Intestinal Inflammation ◽  
Imaging Techniques ◽  
Mr Enterography ◽  
Ultrasound Computed Tomography ◽  
Contrast Enhanced ◽  
Orientation Method ◽  
Conventional Ultrasound

The small intestine is a challenging organ for clinical and radiological evaluation. The introduction of radiological imaging techniques, which do not significantly disturb patients’ comfort and safety, attempts to obtain an adequate diagnosis and valuable information. The aim is to determine the capabilities and potential of ultrasound, computed tomography (CT), diffusion-weighted imaging (DWI), and contrast-enhanced magnetic resonance (MR) enterography to establish the diagnosis and to evaluate the severity and activity of intestinal inflammation. Conventional ultrasound is a suitable orientation method in the initial evaluation of patients with Crohn’s disease. At the same time, contrast-enhanced MR enterography provides an excellent assessment of disease activity, as well as the complications that accompany it. Contrast-enhanced MR enterography, combined with DWI, allows for excellent evaluation of disease activity and problems or difficulties following it. The examination can be repeated, controlled and can monitor patients with this disease.

Mo1230 Contrast-Enhanced Ultrasonography in the Evaluation of Crohn's Disease Activity: Correlation With Ileocolonoscopy

2015 ◽  
Vol 148 (4) ◽  
pp. S-644
Author(s):  
Francisca Dias de Castro ◽  
Joana Magalhaes ◽  
Pedro Boal Carvalho ◽  
Maria Joao Moreira ◽  
Silvia Leite ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Crohn’S Disease Activity

Contrast-enhanced MR enterography as a stand-alone tool to evaluate Crohn's disease in a paediatric population

2013 ◽  
Vol 68 (10) ◽  
pp. 1024-1030 ◽  
Author(s):  
B. Spieler ◽  
N. Hindman ◽  
J. Levy ◽  
K. Zabrieski ◽  
D. Sahlein ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Paediatric Population ◽  
Mr Enterography ◽  
Contrast Enhanced

scholarly journals The Role of MR Enterography in Assessing Crohn’s Disease Activity and Treatment Response

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Matthew P. Moy ◽  
Jenny Sauk ◽  
Michael S. Gee
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Treatment Response ◽  
Imaging Modality ◽  
The United States ◽  
Response To Therapy ◽  
Mr Enterography ◽  
Oral Contrast

MR enterography (MRE) has become the primary imaging modality in the assessment of Crohn’s disease (CD) in both children and adults at many institutions in the United States and worldwide, primarily due to its noninvasiveness, superior soft tissue contrast, and lack of ionizing radiation. MRE technique includes distention of the small bowel with oral contrast media with the acquisition of T2-weighted, balanced steady-state free precession, and multiphase T1-weighted fat suppressed gadolinium contrast-enhanced sequences. With the introduction of molecule-targeted biologic agents into the clinical setting for CD and their potential to reverse the inflammatory process, MRE is increasingly utilized to evaluate disease activity and response to therapy as an imaging complement to clinical indices or optical endoscopy. New and emerging MRE techniques, such as diffusion-weighted imaging (DWI), magnetization transfer, ultrasmall superparamagnetic iron oxide- (USPIO-) enhanced MRI, and PET-MR, offer the potential for an expanded role of MRI in detecting occult disease activity, evaluating early treatment response/resistance, and differentiating inflammatory from fibrotic strictures. Familiarity with MR enterography is essential for radiologists and gastroenterologists as the technique evolves and is further incorporated into the clinical management of CD.

scholarly journals Role of MR Enterography in Evaluation of Disease Activity in Pediatric Crohn’s Disease: Correlation between MR Enterography and Pediatric Crohn’s Disease Activity Index Scores

2020 ◽  
Vol 03 (02) ◽  
pp. 118-125
Author(s):  
Shilpa Radhakrishnan ◽  
Amarnath Chellathurai ◽  
Srinivas Sankaranrayanan ◽  
Dharani Sankar ◽  
Suja Rajan
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Mr Enterography ◽  
Clinical Activity ◽  
Positive Correlation

Abstract Objectives The aim of the study was to assess the role of MR Enterography (MRE) in the diagnosis and follow-up of children with Crohn’s disease (CD) and to correlate disease activity indices with known MRE features of active disease. Methods This was a retrospective study including 24 patients (median age 11 years, 17 males) with clinically and histologically proven CD who underwent MRE. Two previously validated MRE scores—Magnetic Resonance Enterography Global Score (MEGS) and CD MRI index (CDMI)—were calculated. A correlative analysis was made between the Pediatric Crohn’s Disease Activity Index (PCDAI) score and MRE scores as well as individually with each MR variable. Comparison of both the MR scores was made between patients with different disease activity. Results MEGS and PCDAI scores showed strong positive correlation (r = 0.724, p = < 0.001); CDMI and PCDAI scores showed moderate positive correlation (r = 0.661, p = 0.0004). There was statistically significant difference in the MR scores between patients grouped by clinical activity. Among individual MR variables, mural thickness and enhancement best predicted the disease activity. Conclusions MRE-based scores and findings correlate with clinical activity in pediatric CD. Thereby, MRE can be considered a valuable tool in the management of CD, predicting disease activity and offering a potential alternative to endoscopy in monitoring patients during follow-up.

Detection of Crohn’s disease with diffusion images versus contrast-enhanced images in pediatric using MR enterography with histopathological correlation

2019 ◽  
Vol 124 (12) ◽  
pp. 1306-1314
Author(s):  
Gabriele Masselli ◽  
Chiara De Vincentiis ◽  
Marina Aloi ◽  
Marianna Guida ◽  
Roberta Cao ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Mr Enterography ◽  
Histopathological Correlation ◽  
Contrast Enhanced

Evaluation of Crohn’s disease activity by MR enterography: Derivation and histopathological comparison of an MR-based activity index

2015 ◽  
Vol 84 (10) ◽  
pp. 1829-1834 ◽  
Author(s):  
Firdevs Ikbal Gücer ◽  
Senem Senturk ◽  
Seyma Özkanli ◽  
Mehmet Gökce Yilmabasar ◽  
Gupse Adali Köroglu ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Activity Index ◽  
Mr Enterography ◽  
Crohn’S Disease Activity

scholarly journals Assessment of Crohn’s Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations

2019 ◽  
Vol 28 ◽  
pp. 213-224 ◽  
Author(s):  
Laura Maria Minordi ◽  
Luigi Larosa ◽  
Alfredo Papa ◽  
Veronica Bordonaro ◽  
Loris Lopetuso ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Personalized Medicine ◽  
Disease Activity ◽  
Mr Enterography ◽  
Site Assessment ◽  
Hyperintense Signal ◽  
Therapeutic Decisions ◽  
Suitable Treatment

Crohn’s disease (CD) is a chronic inflammatory transmural disease of the gastrointestinal tract. The small bowel is the most frequently involved site. Assessment of the bowel is essential in guiding therapeutic decisions, medical or surgical therapy. Personalized medicine is a new concept that has the potential to improve therapeutic efficacy, reduce the risk of drug adverse events, and decrease costs if the therapy is the most suitable treatment for selected patients. Many techniques have been verified and standardised for small bowel CD. Among radiological techniques, CT enterography (CTE) and MRI-enterography (MRE) are the most widely accepted techniques, although MRI is generally preferable as it avoids radiation. In this review, we will present the current role and new innovative technological perspectives of MR enterography in comparison with clinical and endoscopic evaluations for the assessment of CD activity in adult patients. In particular, many studies have been performed to validate MRE signs such as biomarkers of active Crohn’s disease (such as mural thickening, mural T2 hyperintense signal, target sign, comb sign, ulceration and extramural mesenteric signs) and to select the most appropriate index for identifying active disease or severe inflammation (such as MaRIA score, Clermont index, and others). We conclude that MRE is a minimally invasive tool for the evaluation of disease activity and shows a very good correlation with the presence and severity of endoscopic lesions, so to allow a personalized medicine in patients with CD.

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