Quantitative assessment of terminal ileum motility on MR enterography in Crohn disease: a feasibility study in children

Objectives Investigate the relationship between quantified terminal ileal (TI) motility and histopathological activity grading, Crohn Disease MRI Index (CDMI) and faecal calprotectin. Methods Retrospective review of children with Crohn disease or unclassified inflammatory bowel disease, who underwen...

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Veröffentlicht in:European radiology 2021-02, Vol.31 (2), p.775-784
Hauptverfasser: Cococcioni, Lucia, Fitzke, Heather, Menys, Alex, Gaunt, Trevor, Kumar, Shankar, Kiparissi, Fevronia, Rampling, Dyanne, Palm, Liina, Taylor, Stuart A., Watson, Tom A.
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container_end_page 784
container_issue 2
container_start_page 775
container_title European radiology
container_volume 31
creator Cococcioni, Lucia
Fitzke, Heather
Menys, Alex
Gaunt, Trevor
Kumar, Shankar
Kiparissi, Fevronia
Rampling, Dyanne
Palm, Liina
Taylor, Stuart A.
Watson, Tom A.
description Objectives Investigate the relationship between quantified terminal ileal (TI) motility and histopathological activity grading, Crohn Disease MRI Index (CDMI) and faecal calprotectin. Methods 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. Results 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). Conclusions 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. Key Points • 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.
doi_str_mv 10.1007/s00330-020-07084-1
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Methods 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. Results 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 &gt; 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). Conclusions 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. Key Points • 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.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-020-07084-1</identifier><identifier>PMID: 32833090</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Algorithms ; Biomarkers ; Biopsy ; Child ; Children ; Crohn Disease - diagnostic imaging ; Diagnostic Radiology ; Feasibility Studies ; Humans ; Ileum ; Ileum - diagnostic imaging ; Imaging ; Inflammatory bowel diseases ; Internal Medicine ; Interventional Radiology ; Intestinal motility ; Intestine ; Magnetic Resonance Imaging ; Medical treatment ; Medicine ; Medicine &amp; Public Health ; Motility ; Neuroradiology ; Paediatric ; Radiology ; Retrospective Studies ; Ultrasound</subject><ispartof>European radiology, 2021-02, Vol.31 (2), p.775-784</ispartof><rights>European Society of Radiology 2020</rights><rights>European Society of Radiology 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-139ff12caf686c71f7ec0fed2e70a6c3c66c26dba8d7ac37e0aa3c185b29b87c3</citedby><cites>FETCH-LOGICAL-c419t-139ff12caf686c71f7ec0fed2e70a6c3c66c26dba8d7ac37e0aa3c185b29b87c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-020-07084-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-020-07084-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32833090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cococcioni, Lucia</creatorcontrib><creatorcontrib>Fitzke, Heather</creatorcontrib><creatorcontrib>Menys, Alex</creatorcontrib><creatorcontrib>Gaunt, Trevor</creatorcontrib><creatorcontrib>Kumar, Shankar</creatorcontrib><creatorcontrib>Kiparissi, Fevronia</creatorcontrib><creatorcontrib>Rampling, Dyanne</creatorcontrib><creatorcontrib>Palm, Liina</creatorcontrib><creatorcontrib>Taylor, Stuart A.</creatorcontrib><creatorcontrib>Watson, Tom A.</creatorcontrib><title>Quantitative assessment of terminal ileum motility on MR enterography in Crohn disease: a feasibility study in children</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives Investigate the relationship between quantified terminal ileal (TI) motility and histopathological activity grading, Crohn Disease MRI Index (CDMI) and faecal calprotectin. Methods 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. Results 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 &gt; 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). Conclusions 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. Key Points • 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.</description><subject>Adult</subject><subject>Algorithms</subject><subject>Biomarkers</subject><subject>Biopsy</subject><subject>Child</subject><subject>Children</subject><subject>Crohn Disease - diagnostic imaging</subject><subject>Diagnostic Radiology</subject><subject>Feasibility Studies</subject><subject>Humans</subject><subject>Ileum</subject><subject>Ileum - diagnostic imaging</subject><subject>Imaging</subject><subject>Inflammatory bowel diseases</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Intestinal motility</subject><subject>Intestine</subject><subject>Magnetic Resonance Imaging</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Medicine &amp; 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Methods 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. Results 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 &gt; 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). Conclusions 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. Key Points • 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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32833090</pmid><doi>10.1007/s00330-020-07084-1</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Algorithms
Biomarkers
Biopsy
Child
Children
Crohn Disease - diagnostic imaging
Diagnostic Radiology
Feasibility Studies
Humans
Ileum
Ileum - diagnostic imaging
Imaging
Inflammatory bowel diseases
Internal Medicine
Interventional Radiology
Intestinal motility
Intestine
Magnetic Resonance Imaging
Medical treatment
Medicine
Medicine & Public Health
Motility
Neuroradiology
Paediatric
Radiology
Retrospective Studies
Ultrasound
title Quantitative assessment of terminal ileum motility on MR enterography in Crohn disease: a feasibility study in children
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