Assessing quality of magnetic resonance enterography and its impact on disease assessment of ileal Crohn's disease.

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2024-04-01 Epub Date: 2024-01-05 DOI:10.5217/ir.2023.00095

Anuj Bohra, Declan J Connoley, Danny Con, Jonathan P Segal, Olga Niewiadomski, Abhinav Vasudevan, Daniel R Van Langenberg, Numan Kutaiba

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引用次数: 0

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.

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评估磁共振肠造影的质量及其对回肠克罗恩病疾病评估的影响。

背景/目的：小肠克罗恩病（CD）活动度评估中的磁共振肠成像（MRE）质量评估很少受到关注。我们评估了肠胀气和运动伪影对回肠克罗恩病 MRE 活动指数的影响：方法：我们对 2014 年至 2021 年期间在两个中心同时接受 MRE 和结肠镜检查以评估回肠 CD 的一组患者进行了审核。一位对临床数据保密的腹部放射科医生审查了每份 MRE，按照预先指定的 3 级评分标准对肠道胀气和运动伪影进行了分级，并计算了原始磁共振活动指数（MaRIA）和简化磁共振活动指数（sMaRIA）、伦敦指数和 CD MRE 指数（CDMI）。回肠内镜活动通过 CD 内镜简化评分（SES-CD）进行分级。通过接受者操作特征分析测量了MRE指数在根据MRE质量分层判别活动性疾病（SES-CD≥3）方面的性能：137 名患者在中位 16 天（0-30 天）内进行了 MRE 和结肠镜检查，其中 63 人（46%）表现为活动性疾病（SES-CD ≥3）。由于运动伪影和/或中度至低度膨胀，44 份 MRE（32%）被视为低质量。低质量 MRE 显示回肠 SES-CD ≥3 和 MRE 指数之间的鉴别性能降低（MaRIA 0.838 vs. 0.634，sMaRIA 0.834 vs. 0.527，CDMI 0.850 vs. 0.595，London 0.748 vs. 0.511，PConclusions：图像质量参数会对 MRE 疾病活动性解读产生重大影响。应报告质量指标，以便对质量较低的研究进行谨慎解读。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.