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Dynamic contrast enhanced magnetic resonance imaging of the terminal ileum: differentiation of activity of Crohn’s disease

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Abstract

Aim

To prospectively investigate a new high resolution MRI technique for dynamic evaluation of the enhancement kinetics of bowel parietal layers and to correlate it with CDAI, CRP, endoscopic activity and histologic features.

Methods

About 16 consecutive patients with proven diagnosis of CD underwent ileocolonoscopy with biopsy and serial bowel dynamic contrasted-MRI (D-CE-MRI) evaluated in blind fashion. Quantitative analysis of bowel wall enhancement kinetics was performed basing on signal to noise ratio (SNR) of inner parietal layers (Mucosa–Submucosa, M–SM) and outer parietal layers (Muscular–Serosa, Ms–S). Disease activity was defined by CDAI > 150, serum CRP > 5 mg/dL and histologic results.

Results

About 9 patients showed a layered enhancement of bowel wall (8 active, 1 inactive), whereas inactive (7 cases) group presented a homogeneous pattern. In active patients we found a significant difference in parietal layered enhancement curves (M–SM vs. Ms–S, P < 0.03) not observed in inactive disease and controls (intra-group analysis). M–SM and Ms–S enhanced curves in clinically active patients were significantly different respect to those of patients with inactive CD (P < 0.001) (inter-group analysis). Parietal D-CE-MRI pattern well correlated with histologic features (r = 0.8; P < 0.001, Spearman test).

Conclusions

D-CE-MRI can be a useful tool for clinical follow-up and in the treatment strategies in CD patients.

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References

  1. Bell S, Kamm MA (2000) Antibodies to tumour necrosis factor alpha as treatment for Crohn’s disease. Lancet 355(9207):858–860

    Article  PubMed  CAS  Google Scholar 

  2. Best WR, Becktel JM, Singleton JW, et al. (1976) Development of a Crohn’s disease activity index: National Cooperative Crohn’s Disease Study. Gastroenterology 70(3):439–444

    PubMed  CAS  Google Scholar 

  3. Maccioni F, Viscido A, Broglia L, et al. (2000) Evaluation of Crohn disease activity with magnetic resonance imaging. Abdom Imaging 25(3):219–228

    Article  PubMed  CAS  Google Scholar 

  4. Koh DM, Miao Y, Chinn RJ, et al. (2001) MR imaging evaluation of the activity of Crohn’s disease. AJR 177(6):1325–1332

    PubMed  CAS  Google Scholar 

  5. Born C, Nagel B, Leinsinger G, et al. (2003) MRI with oral filling in patients with chronic inflammatory bowel diseases. Radiologe 43(1):34–42 (in German)

    Article  PubMed  CAS  Google Scholar 

  6. Shoenut JP, Semelka RC, Silverman R, et al. (1993) Magnetic resonance imaging in inflammatory bowel disease. J Clin Gastroenterol 17(1):73–78

    Article  PubMed  CAS  Google Scholar 

  7. Shoenut JP, Semelka RC, Magro CM, et al. (1994) Comparison of magnetic resonance imaging and endoscopy in distinguishing the type and severity of inflammatory bowel disease. J Clin Gastroenterol 19(1):31–35

    Article  PubMed  CAS  Google Scholar 

  8. Schunk K, Kern A, Oberholzer K, et al. (2000) Hydro-MRI in Crohn’s disease: appraisal of disease activity. Invest Radiol 35(7):431–437

    Article  PubMed  CAS  Google Scholar 

  9. Kettritz U, Isaacs K, Warshauer DM, et al. (1995) Crohn’s disease. Pilot study comparing MRI of the abdomen with clinical evaluation. J Clin Gastroenterol 21(3):249–253

    Article  PubMed  CAS  Google Scholar 

  10. Pauls S, Kratzer W, Rieber A, et al. (2003) Quantifying the inflammatory activity in Crohn’s disease using CE dynamic MRI. Rofo 175(8):1093–1099 ?in German?

    PubMed  CAS  Google Scholar 

  11. Laghi A, Borrelli O, Paolantonio P, et al. (2003) Contrast enhanced magnetic resonance imaging of the terminal ileum in children with Crohn’s disease. Gut 52(3):393–397

    Article  PubMed  CAS  Google Scholar 

  12. Low RN, Francis IR, Politoske D, et al. (2000) Crohn’s disease evaluation: comparison of contrast-enhanced MR imaging and single-phase helical CT scanning. J Magn Reson Imaging 11(2):127–135

    Article  PubMed  CAS  Google Scholar 

  13. Danese S, Sans M, de la Motte C, et al. (2006) Angiogenesis as a novel component of inflammatory bowel disease pathogenesis. Gastroenterology 130(7):2060–2073

    Article  PubMed  CAS  Google Scholar 

  14. Brahme F, Lindstrom C (1970) A comparative radiographic and pathological study of intestinal vaso-architecture in Crohn’s disease and in ulcerative colitis. Gut 11(11):928–940

    Article  PubMed  CAS  Google Scholar 

  15. Florie J, Wasser MN, Arts-Cieslik K, et al. (2006) Dynamic contrast-enhanced MRI of the bowel wall for assessment of disease activity in Crohn’s disease. AJR Am J Roentgenol 86(5):1384–1392

    Article  Google Scholar 

  16. Gourtsoyiannis NC, Papanikolaou N, Karantanas A (2006) Magnetic resonance imaging evaluation of small intestinal Crohn’s disease. Best Pract Res Clin Gastroenterol 20(1):137–156 (Review)

    Article  PubMed  Google Scholar 

  17. Rutgeerts P, Geboes K, Vantrappen G, et al. (1990) Predictability of the postoperative course of Crohn’s disease. Gastroenterology 99:956–963

    PubMed  CAS  Google Scholar 

  18. D’Haens GR, Geboes K, Peeters M, et al. (1998) Early lesions of recurrent Crohn’s disease caused by infusion of intestinal contents in excluded ileum. Gastroenterology 114:262–267

    Article  PubMed  CAS  Google Scholar 

  19. Meyers MA, McGuire PV. Spiral CT (1995) demonstration of hypervascularity in Crohn disease: “vascular jejunization of the ileum” or the “comb sign”. Abdom Imaging 20:327–332

    Article  PubMed  CAS  Google Scholar 

  20. Gore RM, Balthazar EJ, Ghahremani GG, et al. (1997) CT features of ulcerative colitis and Crohn’s disease. AJR Am J Roentgenol 69(5):1462–1463

    Google Scholar 

  21. Koutroubakis IE, Xidakis C, Karmiris K, et al. (2004) Serum angiogenin in inflammatory bowel disease. Dig Dis Sci 49(11–12):1758–1762

    Article  PubMed  CAS  Google Scholar 

  22. Karen, et al. (1998) Angiogenin in regulated in vivo as an acute-phase protein. Biochem Biophys Res Commun 242:480–483

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Authors and Affiliations

  1. Department of Radiology, University Campus Bio-Medico, Rome, Italy

    Riccardo Del Vescovo, Ilaria Sansoni, Rosario Francesco Grasso & Bruno Beomonte Zobel

  2. Department of Gastroenterology, University Campus Bio-Medico, Rome, Italy

    Renato Caviglia, Mentore Ribolsi & Michele Cicala

  3. Department of Pathology, University Campus Bio-Medico, Rome, Italy

    Giuseppe Perrone

  4. Medical Faculty, University La Sapienza, Rome, Italy

    Emanuele Leoncini

  5. University Campus Bio-Medico of Rome, Via E. Longoni, 47, 00155, Rome, Italy

    Riccardo Del Vescovo

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  1. Riccardo Del Vescovo
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  2. Ilaria Sansoni
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  9. Bruno Beomonte Zobel
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Correspondence to Riccardo Del Vescovo.

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Del Vescovo, R., Sansoni, I., Caviglia, R. et al. Dynamic contrast enhanced magnetic resonance imaging of the terminal ileum: differentiation of activity of Crohn’s disease. Abdom Imaging 33, 417–424 (2008). https://doi.org/10.1007/s00261-007-9267-4

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  • DOI: https://doi.org/10.1007/s00261-007-9267-4

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