Comparing magnetic resonance enterography and endoscopy findings to the motility of magnetic resonance imaging in pediatric Crohn's disease.

Abstract

Background: Quantitative magnetic resonance imaging (MRI) can evaluate bowel motility in children with Crohn's disease. As inflammation increases, motility decreases.

Objective: Our aim was to show that quantitative MRI correlates with magnetic resonance enterography (MRE). We hypothesize that the motility score will inversely correlate with the Endoscopic Biopsy Acute Histologic Inflammatory Score (eAIS), the Crohn's Disease Endoscopic Index of Severity (CDEIS) score, and the MR Index of Activity (MaRIA) score.

Materials and methods: This was a retrospective study of 50 pediatric patients with ileal and/or cecal Crohn's disease who underwent endoscopy and MRE within 7 days of each other without exposure to therapy. Cine images were used from patients' previously obtained MREs to obtain a motility score using GIQuant (Motilent, London, UK). The relationships between the motility score and MaRIA, eAIS, and CDEIS were then calculated by Spearman's rank correlation coefficient (ρ).

Results: The MaRIA and motility scores inversely correlated (ρ=-0.66, 95%CI (-0.79, -0.46), P<0.0001). MaRIA positively correlated with CDEIS (ρ=0.30, 95%CI (0.02, 0.53), P=0.03) and eAIS (ρ=0.26, 95%CI (0.02, 0.50), P=0.07). The motility score showed a non-significant negative correlation with CDEIS (ρ=-0.17, 95%CI (-0.43, -0.12), P=0.24) and eAIS (ρ=-0.23, 95%CI (-0.48, -0.05), P=0.11).

Conclusion: Quantitative MRI correlates with standard MRE in identifying inflammation of the bowel in Crohn's disease. The cine image used to produce a motility score is obtained faster than standard MRE and does not require the use of intravenous contrast, a spasmolytic agent, and breath-holding techniques.