Intest Res.  2018 Jul;16(3):445-457. 10.5217/ir.2018.16.3.445.

Magnetic resonance enterography predicts the prognosis of Crohn's disease

• Lee JH
• Park YE
• Seo N
• Lee HJ
• Park SJ
• Kim TI
• Kim WH
• Lim JS
• Cheon JH

• KMID: 2417657
• DOI: http://doi.org/10.5217/ir.2018.16.3.445

Abstract

BACKGROUND/AIMS
Magnetic resonance enterography (MRE) has emerged as an important tool in the diagnosis and follow-up of Crohn's disease (CD). The aim of this study was to evaluate whether MRE findings could predict the prognosis of CD.
METHODS
In this retrospective study, a total of 173 patients with clinical remission of CD (n=61) or active CD (n=112) were identified. The outcomes of clinical relapse, admission, surgery, and need for other medications according to the MRE findings were evaluated.
RESULTS
The presence of active inflammation on MRE was observed in 93 (83%) patients with clinically active CD and in 44 (72.1%) patients with clinical remission of CD, without a statistically significant difference (P=0.091). In multivariate analysis, active inflammation on MRE increased the risk for clinical relapse (hazard ratio [HR], 6.985; 95% confidence interval [CI], 1.024-47.649) in patients with clinical remission of CD. In patients with clinically active CD, active inflammation on MRE increased the risk for CD-related hospitalization (HR, 2.970; 95% CI, 1.006-8.772).
CONCLUSIONS
The presence of active inflammation on MRE was significantly associated with poor prognosis both in patients with clinical remission of CD and in those with active CD.

Keyword

Magnetic resonance enterography; Prognosis; Crohn disease

MeSH Terms

Crohn Disease*
Diagnosis
Follow-Up Studies
Hospitalization
Humans
Inflammation
Multivariate Analysis
Prognosis*
Recurrence
Retrospective Studies

Figure

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  Fig. 1 Recruitment algorithm. A total of 243 consecutive patients with magnetic resonance enterography (MRE) were enrolled. After 70 patients were excluded according to our exclusion criteria, a total of 173 patients were selected for statistical analysis.

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  Fig. 2 Cumulative probabilities of a change in relapse (A) and the need for adding other medications or increasing the dose of current medications (B) according to magnetic resonance enterography (MRE) findings at the time of clinical remission.

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  Fig. 3 Cumulative probabilities of a change in admission according to the magnetic resonance enterography (MRE) findings during the clinically active state.

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