Skip to main content
SpringerLink
Log in

Cross-Sectional Imaging Indexes for Crohn’s Disease

  • Chapter
  • First Online:
Cross-Sectional Imaging in Crohn’s Disease

  • 524 Accesses

Abstract

Objective assessment of disease activity and complications in Crohn’s disease (CD) is critical to ensure accurate diagnosis and assessment of therapeutic response in both clinical practice and research. For recent clinical trials, patient selection and trial endpoints have been based on clinical symptoms and mucosal inflammation of the terminal ileum and large bowel determined on ileocolonoscopy. However, cross-sectional imaging methods have definite advantages over ileocolonoscopy and are potentially superior for use in CD clinical practice and trials. The development and validation of objective indexes of activity based on cross-sectional imaging will improve patient selection and assessment of the efficacy of new treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Best W, Becktel J, Singleton JW, Kern F Jr. Development of a Crohn’s disease activity index. National Cooperative Crohn’s Disease Study. Gastroenterology. 1976;70:439–44.

    CAS  PubMed  Google Scholar 

  2. Peyrin-Biroulet L, Reinisch W, Colombel J-F, Mantzaris GJ, Kornbluth A, Diamond R, et al. Clinical disease activity, C-reactive protein normalisation and mucosal healing in Crohn’s disease in the SONIC trial. Gut. 2014;63:88–95.

    Article  Google Scholar 

  3. Lémann M, Mary JY, Colombel JF, Duclos B, Soule JC, Lerebours E, et al. A randomized, double-blind, controlled withdrawal trial in Crohn’s disease patients in long-term remission on azathioprine. Gastroenterology. 2005;128:1812–8.

    Article  Google Scholar 

  4. Allez M, Lemann M, Cattan P, Jian R, Modigliani R. Long term outcome of patients with active Crohn’s disease exhibiting extensive and deep ulcerations at colonoscopy. Am J Gastroenterol. 2002;97:947–53.

    PubMed  Google Scholar 

  5. Gomollón F, Dignass A, Annese V, Tilg H, Van Assche G, Lindsay JO, et al. 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. J Crohns Colitis. 2017;11:3–25.

    Article  Google Scholar 

  6. Jauregui-Amezaga A, Rimola J, Ordás I, Rodríguez S, Ramírez-Morros A, Gallego M, et al. Value of endoscopy and MRI for predicting intestinal surgery in patients with Crohn’s disease in the era of biologics. Gut. 2015;64:1397–402.

    Article  CAS  Google Scholar 

  7. Samuel S, Bruining DH, Loftus EV, Becker B, Fletcher JG, Mandrekar JN, et al. Endoscopic skipping of the distal terminal ileum in Crohn’s disease can lead to negative results from ileocolonoscopy. Clin Gastroenterol Hepatol. 2012;10:1253–9.

    Article  Google Scholar 

  8. Solem CA, Loftus EV, Fletcher JG, Baron TH, Gostout CJ, Petersen BT, et al. Small-bowel imaging in Crohn’s disease: a prospective, blinded, 4-way comparison trial. Gastrointest Endosc. 2008;68:255–66.

    Article  Google Scholar 

  9. García-Bosch O, Ordás I, Aceituno M, Rodríguez S, Ramírez AM, Gallego M, et al. Comparison of diagnostic accuracy and impact of MRI and colonoscopy for the management of Crohn’s disease. J Crohns Colitis. 2016;10:663–9.

    Article  Google Scholar 

  10. Siddiki HA, Fidler JL, Fletcher JG, Burton SS, Huprich JE, Hough DM, et al. Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn’s disease. AJR Am J Roentgenol. 2009;193:113–21.

    Article  Google Scholar 

  11. Girometti R, Zuiani C, Toso F, Brondani G, Sorrentino D. MRI scoring system including dynamic motility evaluation in assessing the activity of Crohn’s disease of the terminal ileum. Acad Radiol. 2008;15:153–64.

    Article  Google Scholar 

  12. Sailer J, Peloschek P, Reinisch W, Vogelsang H, Turetschek K, Schima W. Anastomotic recurrence of Crohn’s disease after ileocolic resection: comparison of MR enteroclysis with endoscopy. Eur Radiol. 2008;18:2512–21.

    Article  Google Scholar 

  13. Hyun SB, Kitazume Y, Nagahori M, Toriihara A, Fujii T, Tsuchiya K, et al. Magnetic resonance enterocolonography is useful for simultaneous evaluation of small and large intestinal lesions in Crohn’s disease. Inflamm Bowel Dis. 2011;17:1063–72.

    Article  Google Scholar 

  14. Laghi A, Borrelli O, Paolantonio P, Dito L, Bueno de Mesquita M, Falconieri P, et al. Contrast enhanced magnetic resonance imaging of the terminal ileum in children with Crohn’s disease. Gut. 2003;52:393–7.

    Article  CAS  Google Scholar 

  15. Neye H, Voderholzer W, Rickes S, Weber J, Wermke W, Lochs H. Evaluation of criteria for the activity of Crohn’s disease by power Doppler sonography. Dig Dis. 2004;22:67–72.

    Article  Google Scholar 

  16. Drews B, Barth TFE, Hänle MM, Muche R, Pauls S, Klaus J, et al. Comparison of sonographically measured bowel wall vascularity, histology, and disease activity in Crohn’s disease. Eur Radiol. 2009;19:1379–86.

    Article  CAS  Google Scholar 

  17. Chiorean MV, Sandrasegaran K, Saxena R, Maglinte DD, Nakeeb A, Johnson CS. Correlation of CT enteroclysis with surgical pathology in Crohn’s disease. Am J Gastroenterol. 2007;102:2541–50.

    Article  Google Scholar 

  18. Faubion WA, Fletcher JG, Byrne SO, Feagan BG, De Villiers WJS, Salzberg B, et al. EMerging BiomARKers in Inflammatory Bowel Disease (EMBARK) study identifies fecal calprotectin, serum MMP9, and serum IL-22 as a novel combination of biomarkers for Crohn’s disease activity: role of cross-sectional imaging. Am J Gastroenterol. 2013;108:1891–900.

    Article  CAS  Google Scholar 

  19. Rimola J, Rodriguez S, Garcia-Bosch O, Ordas I, Ayala E, Aceituno M, et al. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn’s disease. Gut. 2009;58:1113–20.

    Article  CAS  Google Scholar 

  20. Rimola J, Ordás I, Rodriguez S, García-Bosch O, Aceituno M, Llach J, et al. Magnetic resonance imaging for evaluation of Crohnʼs disease. Inflamm Bowel Dis. 2011;17:1759–68.

    Article  Google Scholar 

  21. Ordás I, Rimola J, Rodríguez S, Paredes JM, Martínez-Pérez MJ, Blanc E, et al. Accuracy of magnetic resonance enterography in assessing response to therapy and mucosal healing in patients with Crohn’s disease. Gastroenterology. 2014;146:374–82.

    Article  Google Scholar 

  22. Stoppino LP, Della Valle N, Rizzi S, Cleopazzo E, Centola A, Iamele D, et al. Magnetic resonance enterography changes after antibody to tumor necrosis factor (anti-TNF) alpha therapy in Crohn’s disease: correlation with SES-CD and clinical-biological markers. BMC Med Imaging. 2016;16:1–9.

    Article  Google Scholar 

  23. Takenaka K, Ohtsuka K, Kitazume Y, Nagahori M, Fujii T, Saito E, et al. Correlation of the endoscopic and magnetic resonance scoring systems in the deep small intestine in Crohn’s disease. Inflamm Bowel Dis. 2015;21:1832–8.

    Article  Google Scholar 

  24. Steward MJ, Punwani S, Proctor I, Adjei-Gyamfi Y, Chatterjee F, Bloom S, et al. Non-perforating small bowel Crohn’s disease assessed by MRI enterography: derivation and histopathological validation of an MR-based activity index. Eur J Radiol. 2012;81:2080–8.

    Article  Google Scholar 

  25. Oussalah A, Laurent V, Bruot O, Bressenot A, Bigard M-A, Régent D, et al. Diffusion-weighted magnetic resonance without bowel preparation for detecting colonic inflammation in inflammatory bowel disease. Gut. 2010;59:1056–65.

    Article  Google Scholar 

  26. Hordonneau C, Buisson A, Scanzi J, Goutorbe F, Pereira B, Borderon C, et al. Diffusion-weighted magnetic resonance imaging in ileocolonic Crohn’s disease: validation of quantitative index of activity. Am J Gastroenterol. 2014;109:89–98.

    Article  CAS  Google Scholar 

  27. Buisson A, Pereira B, Goutte M, Reymond M, Allimant C, Obritin-Guilhen H, et al. Magnetic resonance index of activity (MaRIA) and Clermont score are highly and equally effective MRI indices in detecting mucosal healing in Crohn’s disease. Dig Liver Dis. 2017;49:1211–7.

    Article  Google Scholar 

  28. Dohan A, Taylor S, Hoeffel C, Barret M, Allez M, Dautry R, et al. Diffusion-weighted MRI in Crohn’s disease: current status and recommendations. J Magn Reson Imaging. 2016;44:1381–96.

    Article  Google Scholar 

  29. Rimola J, Alvarez-Cofiño A, Pérez-Jeldres T, Ayuso C, Alfaro I, Rodríguez S, et al. Comparison of three magnetic resonance enterography indices for grading activity in Crohn’s disease. J Gastroenterol. 2017;52:585–93.

    Article  Google Scholar 

  30. Tielbeek JAW, Makanyanga JC, Bipat S, Pendsé DA, Nio CY, Vos FM, et al. Grading Crohn disease activity with MRI: interobserver variability of MRI features, MRI scoring of severity, and correlation with Crohn disease endoscopic index of severity. AJR Am J Roentgenol. 2013;201:1220–8.

    Article  Google Scholar 

  31. Gecse KB, Bemelman W, Kamm MA, Stoker J, Khanna R, Ng SC, et al. A global consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising Crohn’s disease. Gut. 2014;63:1381–92.

    Article  Google Scholar 

  32. Schwartz DA, Ghazi LJ, Regueiro M, Fichera A, Zoccali M, Ong EMW, et al. Guidelines for the multidisciplinary management of Crohnʼs perianal fistulas. Inflamm Bowel Dis. 2015;21:723–30.

    Article  Google Scholar 

  33. Horsthuis K, Ziech MLW, Bipat S, Spijkerboer AM, de Bruine-Dobben AC, Hommes DW, et al. Evaluation of an MRI-based score of disease activity in perianal fistulizing Crohn’s disease. Clin Imaging. 2011;35:360–5.

    Article  Google Scholar 

  34. Tozer P, Ng SC, Siddiqui MR, Plamondon S, Burling D, Gupta A, et al. Long-term MRI-guided combined anti-TNF and thiopurine therapy for Crohn’s perianal fistulas. Inflamm Bowel Dis. 2012;18:1825–34.

    Article  Google Scholar 

  35. Van Assche G, Vanbeckevoort D, Bielen D, Coremans G, Aerden I, Noman M, et al. Magnetic resonance imaging of the effects of infliximab on perianal fistulizing Crohn’s disease. Am J Gastroenterol. 2003;98:332–9.

    Article  Google Scholar 

  36. Bell S, Williams A, Wiesel P, Wilkinson K, Cohen R, Kamm M. The clinical course of fistulating Crohn’s disease. Aliment Pharmacol Ther. 2003;17:1145–51.

    Article  CAS  Google Scholar 

  37. Horsthuis K, Lavini C, Bipat S, Stokkers PC, Stoker J. Perianal Crohn disease: evaluation of dynamic contrast-enhanced MR imaging as an indicator of disease activity. Radiology. 2009;251:380–7.

    Article  Google Scholar 

  38. Savoye-Collet C, Savoye G, Koning E, Dacher JN, Lerebours E. Fistulizing perianal Crohn’s disease: contrast-enhanced magnetic resonance imaging assessment at 1 year on maintenance anti-TNF-alpha therapy. Inflamm Bowel Dis. 2011;17:1751–8.

    Article  CAS  Google Scholar 

  39. Karmiris K, Bielen D, Vanbeckevoort D, Vermeire S, Coremans G, Rutgeerts P, et al. Long-term monitoring of infliximab therapy for perianal fistulizing Crohn’s disease by using magnetic resonance imaging. Clin Gastroenterol Hepatol. 2011;9:130–6.

    Article  CAS  Google Scholar 

  40. Samaan MA, Puylaert CAJ, Levesque BG, Zou GY, Stitt L, Taylor SA, et al. The development of a magnetic resonance imaging index for fistulising Crohn’s disease. Aliment Pharmacol Ther. 2017;46:516–28.

    Article  CAS  Google Scholar 

  41. Pariente B, Mary J-Y, Danese S, Chowers Y, De Cruz P, D’Haens G, et al. Development of the Lémann index to assess digestive tract damage in patients with Crohn’s disease. Gastroenterology. 2015;148:52–63.

    Article  Google Scholar 

  42. Gilletta C, Lewin M, Bourrier A, Nion-Larmurier I, Rajca S, Beaugerie L, et al. Changes in the Lémann index values during the first years of Crohn’s disease. Clin Gastroenterol Hepatol. 2015;13:1633–40.

    Article  Google Scholar 

  43. Fiorino G, Bonifacio C, Allocca M, Repici A, Balzarini L, Malesci A, et al. Bowel damage as assessed by the Lémann index is reversible on anti-TNF therapy for Crohn’s disease. J Crohns Colitis. 2015;9:633–9.

    Article  Google Scholar 

  44. Fiorino G, Morin M, Bonovas S, Bonifacio C, Spinelli A, Germain A, et al. Prevalence of bowel damage assessed by cross-sectional imaging in early Crohn’s disease and its impact on disease outcome. J Crohns Colitis. 2017;11:274–80.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Hospital Clínic of Barcelona, CIBEREHD, University of Barcelona, Barcelona, Spain

    Jordi Rimola

Authors
  1. Jordi Rimola
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jordi Rimola .

Editor information

Editors and Affiliations

  1. Department of Radiology, Hospital Clínic of Barcelona, CIBEREHD, University of Barcelona, Barcelona, Spain

    Jordi Rimola

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rimola, J. (2019). Cross-Sectional Imaging Indexes for Crohn’s Disease. In: Rimola, J. (eds) Cross-Sectional Imaging in Crohn’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-96586-4_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-96586-4_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-96585-7

  • Online ISBN: 978-3-319-96586-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation