Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2018; 24(21): 2279-2290
Published online Jun 7, 2018. doi: 10.3748/wjg.v24.i21.2279
Magnetic resonance imaging and Crohn’s disease endoscopic index of severity: Correlations and concordance
Nai-Yi Zhu, Xue-Song Zhao, Fei Miao
Nai-Yi Zhu, Xue-Song Zhao, Fei Miao, Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Author contributions: Zhu NY substantial contributions to conception and design of the study, acquisition of data, drafting the article or making critical revisions related to important intellectual content of the manuscript; Zhao XS analysis and interpretation of data; Miao F final approval of the version of the article to be published.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Ruijin Hospital, Shanghai Jiao Tong University School of Medicine.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Fei Miao, MD, Doctor, Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai 200025, China.
Telephone: +86-21-64085875 Fax: +86-21-64085875
Received: January 19, 2018
Peer-review started: January 19, 2018
First decision: February 3, 2018
Revised: March 28, 2018
Accepted: April 26, 2018
Article in press: April 26, 2018
Published online: June 7, 2018

To examine the correlation between magnetic resonance imaging (MRI) and endoscopic index of severity (CDEIS) in patients with Crohn’s disease (CD).


This was a retrospective study of 104 patients with CD that were treated at the Ruijin Hospital between March 2015 and May 2016. Among them, 61 patients with active CD were evaluated before/after treatment. MRI and endoscopy were performed within 7 d. CDEIS was evaluated. MRI parameters included MaRIA scores, total relative contrast enhancement (tRCE), arterial RCE (aRCE), portal RCE (pRCE), delay phase RCE (dRCE), and apparent diffusion coefficient. The correlation and concordance between multiple MRI findings and CDEIS changes before and after CD treatment were examined.


Among the 104 patients, 61 patients were classified as active CD and 43 patients as inactive CD. Gender, age, disease duration, and disease location were not significantly different between the two groups (all P > 0.05). CRP levels were higher in the active group than in the inactive group (25.12 ± 4.12 vs 5.14 ± 0.98 mg/L, P < 0.001). Before treatment, the correlations between CDEIS and MaRIAs in all patients were r = 0.772 for tRCE, r = 0.754 for aRCE, r = 0.738 for pRCE, and r = 0.712 for dRCE (all MaRIAs, P < 0.001), followed by MRI single indexes. Among the active CD patients, 44 cases were remitted to inactive CD after treatment. The correlations between CDEIS and MaRIAs were r = 0.712 for aRCE, r = 0.705 for tRCE, r = 0.685 for pRCE, and r = 0.634 for dRCE (all MaRIAs, P < 0.001).


Arterial MaRIA should be an indicator for CD follow-up and dynamic assessment. CD treatment assessment was not completely concordant between CDEIS and MRI.

Keywords: Magnetic resonance imaging, Bowel, Crohn’s disease, Crohn’s disease endoscopic index of severity, Concordance

Core tip: Magnetic resonance imaging (MRI) is accurate in evaluating Crohn’s disease (CD) activity and treatment efficacy, but endoscopy (CD endoscopic index of severity) is still the first choice. There are few available data about the concordance between MRI and endoscopy findings before and after treatment. This study provides evidence that MRI indicators are the most sensitive when the disease progresses.