Published in:
01-02-2011 | Gastrointestinal
Derivation of a T2-weighted MRI total colonic inflammation score (TCIS) for assessment of patients with severe acute inflammatory colitis—a preliminary study
Published in: European Radiology | Issue 2/2011
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Objective
To derive an MRI score for assessing severity, therapeutic response and prognosis in acute severe inflammatory colitis.
Methods
Twenty-one patients with acute severe colitis underwent colonic MRI after admission and again (n = 16) after median 5 days of treatment. Using T2-weighted images, two radiologists in consensus graded segmental haustral loss, mesenteric and mural oedema, mural thickness, and small bowel and colonic dilatation producing a total colonic inflammatory score (TCIS, range 6–95). Pre- and post-treatment TCIS were compared, and correlated with CRP, stool frequency, and number of inpatient days (therapeutic response marker). Questionnaire assessment of patient worry, satisfaction and discomfort graded 1 (bad) to 7 (good) was administered
Results
Admission TCIS correlated significantly with CRP (Kendall’s tau=0.45, 95% confidence interval [CI] 0.11–0.79, p = 0.006), and stool frequency (Kendall’s tau 0.39, 95% CI 0.14-0.64, p = 0.02). TCIS fell after treatment (median [22 range 15–31]) to median 20 [range 8–25], p = 0.01. Admission TCIS but not CRP or stool frequency was correlated with length of inpatient stay (Kendall’s tau 0.40, 95% CI 0.11–0.69, p = 0.02). Patients reported some discomfort (median score 4) during MRI.
Conclusions
MRI TCIS falls after therapy, correlates with existing markers of disease severity, and in comparison may better predict therapeutic response.