Agreement between real-time elastography and delayed enhancement magnetic resonance enterography on quantifying bowel wall fibrosis in Crohn's disease. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Mazza, Stefano; Conforti, Francesco Simone; Forzenigo, Laura Virginia; Piazza, Nicole; Bertè, Roberto; Costantino, Andrea; Fraquelli, Mirella; Coletta, Marina; Rimola, Jordi; Vecchi, Maurizio; Caprioli, Flavio
• Is Part Of: Digestive and liver disease. Volume 54:Issue 1(2022)
• Page Start: 69
• Page End: 75
• Publication Date: 2022-01
• Subjects: Fibrosis -- Crohn's disease -- Real-time elastography -- Magnetic resonance imaging; %EG percentage of enhancement gain between 70 s and 7 min -- CD Crohn's disease -- DE-MRE delayed-enhancement magnetic resonance enterography -- MRE magnetic resonance enterography -- MRI magnetic resonance imaging -- RTE real-time elastography -- SR strain ratio -- US Ultrasound -- WSI wall signal intensity; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2021.05.018
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: the assessment of fibrosis in Crohn's disease (CD) bowel lesions helps to guide therapeutic decisions. Real-time elastography (RTE) and delayed-enhancement magnetic resonance enterography (DE-MRE) have demonstrated good accuracy in quantifying CD-related ileal fibrosis as compared with histological examination. To date no study has compared DE-MRE and RTE. Aims: we aimed to evaluate the agreement between RTE and DE-MRE on quantifying CD-related ileal fibrosis. Methods: consecutive patients with ileal or ileocolonic CD underwent RTE and DE-MRE. Ileal fibrosis was quantified by calculating the strain ratio (SR) at RTE and the 70s-7 min percentage of enhancement gain (%EG) of both mucosa and submucosa at DE-MRE. A SR ≥2 was applied to define severe fibrosis. Clinically relevant outcomes occurring at follow-up were recorded. Results: 40 CD patients were enrolled. A significant linear correlation was observed between SR and submucosal %EG ( r = 0.594, p < 0.001). Patients with severe fibrosis (SR ≥2) had significantly higher submucosal %EG values than patients with low/moderate fibrosis (median values 26.4% vs . 9.5%, p < 0.001). During a median 43.8-month follow-up relevant disease outcomes occurred more frequently in the severe-fibrosis group (75% vs . 36%, HR 5.4, 95% CI 1.2–24.6, p = 0.029). Conclusions: the study demonstrates an excellent agreement between RTE and DE-MRE in assessing ileal fibrosis in CD.