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01-02-2014 | Gastrointestinal

Evaluation of Crohn’s disease activity: Initial validation of a magnetic resonance enterography global score (MEGS) against faecal calprotectin

Authors: Jesica C. Makanyanga, Doug Pendsé, Nikolaos Dikaios, Stuart Bloom, Sara McCartney, Emma Helbren, Elaine Atkins, Terry Cuthbertson, Shonit Punwani, Alastair Forbes, Steve Halligan, Stuart A. Taylor

Published in: European Radiology | Issue 2/2014

Abstract

Objectives

To develop an MRI enterography global score (MEGS) of Crohn’s disease (CD) activity compared with a reference standard of faecal calprotectin (fC), C-reactive protein (CRP) and Harvey-Bradshaw index (HBI).

Methods

Calprotectin, CRP and HBI were prospectively recorded for 71 patients (median age 33, male 35) with known/suspected CD undergoing MRI enterography. Two observers in consensus scored activity for nine bowel segments, grading mural thickness, T2 signal, mesenteric oedema, T1 enhancement and pattern, and haustral loss. Segmental scores were multiplied according to disease length. Five points each were added for lymphadenopathy, comb sign, fistulae and abscesses to derive the MEGS. A previously validated MRI CD activity score (CDAS) was also calculated. MRI scores were correlated with clinical references using Spearman’s rank. A logistic regression diagnostic model was built to discriminate active (fC > 100 μg/g) from inactive disease.

Results

MEGS and CDAS were significantly correlated with fC (r = 0.46, P < 0.001) and (r = 0.39, P = 0.001) respectively. MEGS correlated with CRP (r = 0.39, P = 0.002). The model for discriminating active from inactive disease achieved an area under the receiver-operating curve of 0.75 and 0.66 after leave-one-out analysis.

Conclusion

A magnetic resonance enterography global score (MEGS) of CD activity correlated significantly with fC levels.

Key Points

• Magnetic resonance imaging is now widely used to assess Crohn’s disease.

• Existing MRI activity scores depend on local segmental endoscopic/histological reference standards.

• Scores including assessment of disease extent/complications better demonstrate full disease burden.

• This new global Crohn’s disease burden score correlates with calprotectin and CRP.

• The MRI enterography score of disease activity can complement existing clinical markers.

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Title: Evaluation of Crohn’s disease activity: Initial validation of a magnetic resonance enterography global score (MEGS) against faecal calprotectin
Authors: Jesica C. Makanyanga
Doug Pendsé
Nikolaos Dikaios
Stuart Bloom
Sara McCartney
Emma Helbren
Elaine Atkins
Terry Cuthbertson
Shonit Punwani
Alastair Forbes
Steve Halligan
Stuart A. Taylor
Publication date: 01-02-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-3010-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Evaluation of Crohn’s disease activity: Initial validation of a magnetic resonance enterography global score (MEGS) against faecal calprotectin

Abstract

Objectives

Methods

Results

Conclusion

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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