# Comparative Assessment of Crohn's Disease Activity Using Magnetic Resonance Enterography and Endoscopy

## TL;DR

This study compares MRI scans and endoscopy for assessing Crohn's disease activity, finding MRI to be a useful non-invasive alternative.

## Contribution

The study evaluates MRE's effectiveness against endoscopy for Crohn's disease activity assessment.

## Key findings

- MRE showed 83.3% sensitivity and 60% specificity in detecting active Crohn's disease.
- Agreement between MRE and endoscopy was fair to good (Kappa = 0.347).
- MRE can detect bowel changes near the ileocecal junction that endoscopy misses.

## Abstract

Introduction

Magnetic resonance enterography (MRE) has emerged as a promising technique for evaluating the extent and severity of Crohn's disease activity. To compare how we measure Crohn's disease activity with MRE and endoscopy.

Material and methods

We retrospectively reviewed MRE studies of 60 patients with suspicious Crohn's disease who underwent 1.5-T MRI examinations (T1-weighted images pre- and post-IV contrast medium administration and T2-weighted images) and endoscopy within one month, and they were evaluated by one radiology consultant with experience of 17 years. Endoscopy was used as the reference standard for diagnosing active Crohn's disease cases. Data analysis was performed using the websites (www.graphpad.com and www.medcalc.org) and Microsoft Excel (Microsoft® Corp., Redmond, USA).

Results

A total of 35 patients were included in the study. The remaining 25 patients were excluded either due to non-available data in the endoscopy report or cases of non-Crohn's disease. The MRI examinations were reviewed by one radiology consultant and revealed 27 active and eight non-active Crohn's disease cases compared to 30 active and five non-active Crohn's disease cases in endoscopy. The sensitivity of MRI in detecting active cases of Crohn's disease compared to endoscopy was 83.3% and the specificity of 60%. The strength of agreement between both methods was fair to good (Kappa = 0.347, p-value = 0.4497, Chi-squared = 0.571 with one degree of freedom).

Conclusion

MRE statistically has a good impact on the assessment of Crohn's disease as well as endoscopy with the parameters used in this study. Non-invasiveness and the changes of activity seen in the bowel proximal to the ileocecal junction undetectable by endoscopy make MRE more practically applicable in this aspect.