Magnetic resonance imaging and Crohn’s disease endoscopic index of severity: Correlations and concordance

Table 1 Characteristics of the patients before treatments

	All n = 104	Active n = 61	Inactive n = 43	P value
Gender (M/F)	59/45	36/25	23/20	0.230
Age	31.37 ± 9.56	27.5 ± 11.4	34.44 ± 5.37	0.650
Disease duration	3.5	3.9	3.3	0.550
Disease location
Rectum	0	0	0
Sigmoid/left colon	4	2	2
Transverse colon	14	7	7
Right colon	16	10	6
Ileum	70	42	28
Treatment regimen
Glucocorticoid	23	23	0
IFX	18	18	0
ADA	20	20	0
Edema	61	61	0	< 0.001
Reactive lymph nodes	25	16	9	0.311
Mucosal ulcer	49	38	11	< 0.001
Enhancement pattern	61	61	0	0.006
Morphological changes	31	12	19	0.023
Perienteric exudation	38	38	0	< 0.001
CRP (mg/L)	18.34 ± 8.45	25.12 ± 4.12	5.14 ± 0.98	< 0.001
ADC (mm2/s)	1.87 ± 0.471	1.598 ± 0.383	1.949 ± 0.431	0.001
Thickness (mm)	7.89 ± 3.23	9.23 ± 3.36	6.75 ± 2.49	0.001
tRCE (%)	78.34 ± 45.34	92.153 ± 101.34	40.592 ± 11.019	0.017
aRCE (%)	124.45 ± 61.11	181.46 ± 97.80	92.63 ± 45.48	< 0.001
pRCE (%)	254.21 ± 198.22	321.90 ± 231.03	201.32 ± 124.66	0.020
dRCE (%)	377.15 ± 223.21	466.18 ± 260.08	271.91 ± 209.66	0.002
MaRIA
tRCE	20.37 ± 3.42	26.18 ± 5.02	6.44 ± 1.03	< 0.001
aRCE	18.88 ± 4.11	28.40 ± 4.84	6.43 ± 2.74	< 0.001
pRCE	26.32 ± 2.89	35.09 ± 4.64	6.94 ± 2.58	< 0.001
dRCE	19.26 ± 3.21	36.81 ± 5.11	7.25 ± 2.32	0.001
CDEIS	8.15 ± 4.03	10.57 ± 3.02	3.46 ± 1.23	0.001

IFX: Infliximab; ADA: Adalimumab; CRP: C-reactive protein; ADC: Apparent diffusion coefficient; tRCE: Total relative contrast enhancement; aRCE: Arterial relative contrast enhancement; pRCE: Portal phase relative contrast enhancement; dRCE: Delay phase relative contrast enhancement; MaRIA: Magnetic resonance index of activity; CDEIS: Crohn’s disease endoscopic index of severity.

Table 2 Correlations between magnetic resonance indicators and Crohn’s disease endoscopic index of severity before treatment in the two groups

	All n = 104		Active group n = 61		Inactive group n = 43
	r	P value	r	P value	r	P value
ADC	-0.276	0.012	-0.207	0.016	-0.202	0.356
Thickness	0.356	0.001	0.311	0.002	0.952	0.013
tRCE	0.661	< 0.001	0.726	< 0.001	0.718	< 0.001
aRCE	0.634	< 0.001	0.548	< 0.001	0.238	0.274
pRCE	0.519	< 0.001	0.540	< 0.001	0.921	0.022
dRCE	0.507	< 0.001	0.459	< 0.001	0.022	0.920
MaRIA
tRCE	0.772	< 0.001	0.789	< 0.001	0.746	< 0.001
aRCE	0.754	< 0.001	0.767	< 0.001	0.334	0.288
pRCE	0.738	< 0.001	0.745	< 0.001	0.230	0.471
dRCE	0.712	< 0.001	0.718	< 0.001	0.280	0.378
CDEIS	8.15 ± 4.03		10.57 ± 3.02		3.46 ± 1.23

ADC: Apparent diffusion coefficient; tRCE: Total relative contrast enhancement; aRCE: Arterial relative contrast enhancement; pRCE: Portal phase relative contrast enhancement; dRCE: Delay phase relative contrast enhancement; MaRIA: Magnetic resonance index of activity; CDEIS: Crohn’s disease endoscopic index of severity.

Table 3 Correlations between magnetic resonance imaging indicators and Crohn’s disease endoscopic index of severity in the 61 active Crohn’s disease patients after treatment

	CDEIS			ΔCDEIS
	r	P value		r	P value
ADC	-0.467	< 0.001	ΔADC	-0.545	0.001
Thickness	0.242	0.201	Δthickness	0.407	0.148
tRCE	0.548	0.002	ΔtRCE	0.467	0.018
aRCE	0.619	< 0.001	ΔaRCE	0.593	0.002
pRCE	0.493	0.008	ΔpRCE	0.529	0.004
dRCE	0.490	0.015	ΔdRCE	0.512	0.003
MaRIA			ΔMaRIA
tRCE	0.736	< 0.001	tRCE	0.724	< 0.001
aRCE	0.771	< 0.001	aRCE	0.781	< 0.001
pRCE	0.740	< 0.001	pRCE	0.724	< 0.001
dRCE	0.755	< 0.001	dRCE	0.760	< 0.001

ADC: Apparent diffusion coefficient; tRCE: Total relative contrast enhancement; aRCE: Arterial relative contrast enhancement; pRCE: Portal phase relative contrast enhancement; dRCE: Delay phase relative contrast enhancement; MaRIA: Magnetic resonance index of activity; CDEIS: Crohn’s disease endoscopic index of severity.

Table 4 Subgroups in the active Crohn’s disease patients according to disease activity after treatments

	Remained active (n = 17)		Improved to inactive (n = 44)		P value
	Pre-treatment	Post-treatment	Pre-treatment	Post-treatment
Gender (M/F)	10/7		26/18		0.332
Age	30.4 ± 5.5		26.7 ± 10.1		0.563
Disease duration	1-5		1-5
Disease location					0.916
Sigmoid/left colon	1		1
Transverse colon	3		4
Right colon	4		6
Ileum	14		28
Treatment regimen					0.292
Glucocorticoids	8		15
Infliximab	6		12
Adalimumab	3		17
CRP	28.01 ± 5.22		20.91 ± 5.45		0.054
CDEIS	12.23 ± 5.12	10.47 ± 3.43	10.12 ± 2.11	3.11 ± 0.21	0.001
CRP	28.01 ± 5.215	15.12 ± 4.32	20.91 ± 5.45	5.84 ± 0.743	0.002
ADC	1.52 ± 0.12	1.44 ± 0.34	1.59 ± 0.17	1.73 ± 0.2	0.001
Thickness	9.12 ± 1.21	7.66 ± 1.41	8.2 ± 2.22	5.42 ± 1.32	0.012
tRCE	89.14 ± 13.33	69.49 ± 12.11	82.11 ± 12.47	45.32 ± 4.53	0.021
aRCE	179.03 ± 20.66	166.16 ± 22.44	181.14 ± 34.1	89.76 ± 12.71	0.001
pRCE	330.02 ± 67.12	285.27 ± 57.71	301.32 ± 54.12	199.23 ± 23.2	0.001
dRCE	453.29 ± 54.05	385.5 ± 45.32	440.18 ± 33.09	257.22 ± 44.13	0.001
MaRIA
tREC	35.17 ± 5.66	30.12 ± 3.12	26.56 ± 2.90	6.23 ± 1.11	< 0.001
aRCE	28.22 ± 6.76	19.12 ± 4.09	29.47 ± 5.22	6.48 ± 1.38	< 0.001
pRCE	37.79 ± 5.59	29.21 ± 4.21	36.28 ± 4.72	7.11 ± 1.74	< 0.001
dRCE	36.09 ± 8.12	25.2 ± 5.77	27.08 ± 5.79	7.22 ± 1.59	< 0.001
ESR	24.186 ± 3.210	18.28 ± 3.38	21.49 ± 3.33	3.184 ± 0.568	< 0.001

CRP: C-reactive protein; ADC: Apparent diffusion coefficient; tRCE: Total relative contrast enhancement; aRCE: Arterial relative contrast enhancement; pRCE: Portal phase relative contrast enhancement; dRCE: Delay phase relative contrast enhancement; MaRIA: Magnetic resonance index of activity; CDEIS: Crohn’s disease endoscopic index of severity; ESR: Erythrocyte sedimentation rate.

Table 5 Correlations between magnetic resonance indicators and Crohn’s disease endoscopic index of severity in the active group according to disease activity after treatment

	Remained active n = 17		Improved to inactive n = 44
	r	P value	r	P value
ADC	-0.219	0.518	-0.516	0.002
Thickness	0.105	0.758	0.170	0.568
tRCE	0.356	0.203	0.420	0.005
aRCE	0.376	0.255	0.697	0.002
pRCE	0.305	0.113	0.350	0.010
dRCE	0.381	0.134	0.341	0.015
MaRIA
tRCE	0.268	0.400	0.705	< 0.001
aRCE	0.268	0.399	0.712	< 0.001
pRCE	0.306	0.334	0.685	< 0.001
dRCE	0.309	0.329	0.634	< 0.001

ADC: Apparent diffusion coefficient; tRCE: Total relative contrast enhancement; aRCE: Arterial relative contrast enhancement; pRCE: Portal phase relative contrast enhancement; dRCE: Delay phase relative contrast enhancement; MaRIA: Magnetic resonance index of activity.