Quantitative assessment of terminal ileum motility on MR enterography in Crohn disease: a feasibility study in children
Autor: | Shankar Kumar, Liina Palm, Trevor Gaunt, H Fitzke, Dyanne Rampling, Stuart A. Taylor, Lucia Cococcioni, Alex Menys, Fevronia Kiparissi, Tom A. Watson |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Crohn disease Ultrasound Motility Interventional radiology General Medicine medicine.disease Gastroenterology Inflammatory bowel disease Faecal calprotectin 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Internal medicine medicine Terminal ileum Radiology Nuclear Medicine and imaging Radiology business Neuroradiology |
Zdroj: | European Radiology. 31:775-784 |
ISSN: | 1432-1084 0938-7994 |
Popis: | Investigate the relationship between quantified terminal ileal (TI) motility and histopathological activity grading, Crohn Disease MRI Index (CDMI) and faecal calprotectin. Retrospective review of children with Crohn disease or unclassified inflammatory bowel disease, who underwent MR enterography. Dynamic imaging for 25 patients (median age 12, range 5 to 16) was analysed with a validated motility algorithm. The TI motility score was derived. The primary reference standard was TI Endoscopic biopsy Assessment of Inflammatory Activity (eAIS) within 40 days of the MR enterography. Secondary reference standards: (1) the Crohn Disease MRI Index (CDMI) and (2) faecal calprotectin levels. MR enterography median motility score was 0.17 a.u. (IQR 0.12 to 0.25; range 0.05 to 0.55), and median CDMI was 3 (IQR 0 to 5.5). Forty-three percent of patients had active disease (eAIS > 0) with a median eAIS score of 0 (IQR 0 to 2; range 0 to 5). The correlation between eAIS and motility was r = − 0.58 (p = 0.004, N = 23). Between CDMI and motility, r = − 0.42 (p = 0.037, N = 25). Motility score was lower in active disease (median 0.12 vs 0.21, p = 0.020) while CDMI was higher (median 5 vs 1, p = 0.04). In a subset of 12 patients with faecal calprotectin within 3 months of MR enterography, correlation with motility was r = − 0.27 (p = 0.4). Quantified terminal ileum motility decreases with increasing histopathological abnormality in children with Crohn disease, reproducing findings in adults. TI motility showed a negative correlation with an MRI activity score but not with faecal calprotectin levels. • It is feasible to perform MRI quantified bowel motility assessment in children using free-breathing techniques. • Bowel motility in children with Crohn disease decreases as the extent of intestinal inflammation increases. • Quantified intestinal motility may be a candidate biomarker for treatment efficacy in children with Crohn disease. |
Databáze: | OpenAIRE |
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