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Acad Radiol. 2008 Feb;15(2):153-64. doi: 10.1016/j.acra.2007.08.010.

MRI scoring system including dynamic motility evaluation in assessing the activity of Crohn's disease of the terminal ileum.

Author information

1
Institute of Radiology, University of Udine, via Colugna n. 50, 33100 Udine, Italy. rgirometti@sirm.org

Abstract

RATIONALE AND OBJECTIVES:

We sought to investigate the value of a MRI scoring system including dynamic motility evaluation in the assessment of small bowel Crohn's disease activity.

MATERIALS AND METHODS:

From March 2005 to December 2006, 52 patients with suspected Crohn's disease onset or relapse underwent MRI on a 1.5-T magnet. Bowel distention was achieved orally assuming a mean of 1.6 L of a polyethyleneglycol (PEG) preparation. Per-patient assessment of disease activity was based on a scoring system including evaluation of morphology and motility of the small bowel and perivisceral structures (true-FISP, cine-true-FISP, and HASTE T2W sequences) and dynamic assessment of parietal contrast enhancement (FLASH T1W sequence). Patients were included in three categories, using endoscopic biopsy as the standard reference: no activity/quiescent disease, mild activity, or moderate-to-severe activity. Patients without terminal ileum involvement were excluded from data analysis.

RESULTS:

MRI allowed a detailed and panoramic evaluation of the small bowel in all subjects examined. MRI properly assessed 14 of 16 (87.5%) cases of no activity/quiescent disease, 12 of 14 (85.7%) cases of mild activity, and 15 of 15 (100%) cases of severe activity. Overall, activity score led to a per-patient misdiagnosis of disease activity in a nonsignificant proportion of subjects (4 of 45; 8.8%) (P > .05), determining two false-positive and two false-negative results of mild disease activity. Sensitivity, specificity, PPV, NPV, and overall accuracy in assessing disease activity were 93.1%, 87.5%, 93.1%, 87.5%, and 91.1%, respectively.

CONCLUSION:

Accurate assessment of Crohn's disease activity is achieved by using an activity score providing an overall interpretation of MRI findings.

PMID:
18206614
DOI:
10.1016/j.acra.2007.08.010
[Indexed for MEDLINE]

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