Findings of ulceration and severe stricture on MRE can predict prognosis of Crohn’s disease in patients treated with anti-TNF treatment

Makoto Naganuma, Shigeo Okuda, Tadakazu Hisamatsu, Katsuyoshi Matsuoka, Kiyoto Mori, Naoki Hosoe, Yoshihiro Nakazato, Haruhiko Ogata, Takanori Kanai

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: MR enterography (MRE) is useful for evaluating transmural lesions and extra-intestinal complications of Crohn’s disease (CD). The aim of this study was to prospectively evaluate whether MRE could detect severe strictures and inflammatory lesions in patients who lost the responsiveness to anti-TNF treatment and whether MRE could predict prognosis of CD patients with clinical remission. Patients and methods: MRE were conducted in 50 patients who were treated with infliximab or adalimumab. The main aims of this study were as follows; (1) to compare the rates of CD lesions of the patients with clinical remission and active disease at the baseline and (2) to assess the MRE findings that were predictors of clinical recurrence among patients with clinical remission at the baseline. Results: The MRE detection rates of markedly increased contrast uptake, severe strictures, and the presence of ulcers were significantly higher in patients with Crohn Disease Activity Index ≥150 than in patients with clinical remission. Over a mean follow-up of 18.2 months, the absence of ulceration (p = 0.001) or severe stricture (p = 0.01) prolonged clinical recurrence among patients with clinical remission at baseline. Expected duration of recurrence significantly prolonged in patients with total magnetic resonance index of activity (MaRIA) <36.3 [29.8 months (95% CI 23.7–35.9)] than in patients with total MaRIA ≥36.3 (13.9 months (95% CI 7.7–20.1). A cut-off value of total MaRIA score of 36.3 had a sensitivity of 75% and specificity of 70% for predicting recurrence. Conclusion: Findings of ulceration and severe stricture on MRE predict prognosis of CD patients who were treated with anti-TNF treatment. MRE might be useful for making treatment decisions in patients who lost the effectiveness of medical treatments.

Original languageEnglish
Pages (from-to)141-151
Number of pages11
JournalAbdominal Radiology
Volume42
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

Keywords

  • Anti-TNF treatment
  • Crohn’s disease
  • MR enterography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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