Assessing Quality of Magnetic Resonance Enterography and Its Impact on Disease Assessment of Ileal Crohn's Disease

Overview

Journal Intest Res

Date 2024 Jan 4

PMID 38173229

Authors

Anuj Bohra

Declan J Connoley

Danny Con

Jonathan P Segal

Olga Niewiadomski

Abhinav Vasudevan

Daniel R van Langenberg

Numan Kutaiba

Affiliations

Soon will be listed here.

Abstract

Background/aims: Assessment of quality of magnetic resonance enterography (MRE) in small bowel Crohn's disease (CD) activity evaluation has received little attention. We assessed the impact of bowel distention and motion artifact on MRE activity indices in ileal CD.

Methods: A cohort of patients who underwent contemporaneous MRE and colonoscopy for ileal CD assessment between 2014 and 2021 at 2 centers were audited. An abdominal radiologist blinded to clinical data reviewed each MRE, graded bowel distention and motion artifact upon a pre-specified 3-point scale and calculated the original magnetic resonance index of activity (MaRIA) and simplified MaRIA (sMaRIA), London index and CD MRE index (CDMI). Ileal endoscopic activity was graded via the Simplified Endoscopy Score for CD (SES-CD). The performance of MRE indices in discriminating active disease (SES-CD ≥3) stratified by MRE quality was measured by receiver operator characteristic analyses.

Results: One hundred and thirty-seven patients had MRE and colonoscopy within a median of 16 days (range, 0-30 days) with 63 (46%) exhibiting active disease (SES-CD ≥3). Forty-four MREs (32%) were deemed low quality due to motion artifact and/or moderate to poor distention. Low-quality MREs demonstrated reduced discriminative performance between ileal SES-CD ≥3 and MRE indices (MaRIA 0.838 vs. 0.634, sMaRIA 0.834 vs. 0.527, CDMI 0.850 vs. 0.595, London 0.748 vs. 0.511, P<0.05 for all). Individually the presence of any motion artifact markedly impacted the discriminative performance (e.g., sMaRIA area under the curve 0.544 vs. 0.814, P<0.05).

Conclusions: Image quality parameters can significantly impact MRE disease activity interpretation. Quality metrics should be reported, enabling cautious interpretation in lower-quality studies.

Citing Articles

Bowel preparation after mid-gut tubing enhanced the efficacy and compliance of magnetic resonance enterography in Crohn's disease: a randomized controlled trial.

Wang Y, Dai M, Zheng M, Jin Y, Wen Q, Cui B Therap Adv Gastroenterol. 2024; 17:17562848241275337.

PMID: 39346010 PMC: 11437563. DOI: 10.1177/17562848241275337.

Achieving high-quality magnetic resonance enterography is critical for assessing Crohn's disease activity.

Song K Intest Res. 2024; 22(2):117-118.

PMID: 38720468 PMC: 11079509. DOI: 10.5217/ir.2024.0043.

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