Journal article
Changes in the Management of Patients with Crohn's Disease Based on Magnetic Resonance Enterography Patterns
Gastroenterology research and practice, Vol.2019(2019), pp.1-9
2019
DOI: 10.1155/2019/3467316
PMCID: PMC6942861
PMID: 31933630
Abstract
Background and Aims. Magnetic resonance enterography (MRE) has become an important modality of radiological imaging in the evaluation of Crohn's disease (CD). The aim of this study was to investigate the impact of MRE in the assessment of disease activity and abdominal complications and in the making of therapeutic decisions for patients with CD. Methods. In a cross-sectional retrospective study, we selected 74 patients with CD who underwent MRE and ileocolonoscopy with an interval between the two exams of up to 30 days between January 2011 and December 2017. We assessed the parameters of the images obtained by MRE and investigated the agreement with the level of disease activity and complications determined by a clinical evaluation, inflammatory biomarkers, and endoscopy, as well as the resulting changes in medical and surgical management. Results. Changes in medical management were detected in 41.9% of patients. Significant changes in medical decisions were observed in individuals with a purely penetrating (P=.012) or a mixed (P=.024) MRE pattern. Patients with normal MRE patterns had a correlation with unchanged medical decisions (P=.001). There were statistically significant agreements between the absence of inflammatory criteria on MRE and remission according to the Harvey and Bradshaw index (HBI) (P=.037), the presence of inflammatory criteria on MRE and positive results for calprotectin (P=.005), and penetrating criteria on MRE and the scoring endoscopic system for Crohn's disease (SES-CD), indicating active disease (P=.048). Finally, there was significant agreement between the presence of fibrostenotic criteria and a long disease duration (P=.027). Conclusion. MRE discloses disease activity and complications not apparent with other modalities and results in changes in therapeutic decisions. In addition to being used for diagnosis, MRE should be routinely used in the follow-up of CD patients.
Details
- Title: Subtitle
- Changes in the Management of Patients with Crohn's Disease Based on Magnetic Resonance Enterography Patterns
- Creators
- Evelyn Sayuri S. Chinem - Universidade do Estado do Rio de JaneiroBarbara C. Esberard - Universidade do Estado do Rio de JaneiroAndre da L. Moreira - Univ Estado Rio de Janeiro, Disciplina Proctol, BR-20551900 Rio De Janeiro, RJ, BrazilTatiana G. Barbassa - Centrus Diagnósticos por ImagemGuilherme M. da Cunha - CDPI DASA Clin Diagnoost Imagem Diagnost Amer SA, BR-22440032 Rio De Janeiro, RJ, BrazilAntonio Jose de V. Carneiro - Univ Fed Rio de Janeiro, Serv Gastroenterol, Dept Clin Med, BR-21941913 Rio De Janeiro, RJ, BrazilHeitor S. de Souza - Universidade Federal do Rio de JaneiroAna Teresa P. Carvalho - Universidade do Estado do Rio de Janeiro
- Resource Type
- Journal article
- Publication Details
- Gastroenterology research and practice, Vol.2019(2019), pp.1-9
- DOI
- 10.1155/2019/3467316
- PMID
- 31933630
- PMCID
- PMC6942861
- NLM abbreviation
- Gastroenterol Res Pract
- ISSN
- 1687-6121
- eISSN
- 1687-630X
- Publisher
- Wiley
- Number of pages
- 9
- Grant note
- 302401/2016-4 / Brazilian Research Council (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)); Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPQ) CDPI (Clinica de Diagnoostico por Imagem) E26/202.781/2017 / FAPERJ (Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro); Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio De Janeiro (FAPERJ)
- Language
- English
- Date published
- 2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985175013202771
Metrics
1 Record Views