, Volume 37, Issue 6, pp 958-966

Imaging indexes of activity and severity for Crohn’s disease: current status and future trends

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Abstract

Background

Cross-sectional imaging techniques, including ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) are increasingly used for evaluation of Crohn’s disease (CD).

Aim

To review the accuracy of cross-sectional imaging indexes for measurement of disease activity and severity in patients with CD, and to evaluate its applicability on daily clinical practice and research.

Methods

Relevant publications were identified by literature search, and selected based on predefined quality parameters, including a sample size and reference standard. Nineteen publications were chosen.

Results

The US-based indexes of activity showed high correlation with reference standard indexes. There is a good or very good agreement between the MR-based indexes and the reference standard when the comparison is limited to small segments of intestine. Significant discrepancies have been found between indexes that evaluate the colon. Only one CT-based index was included. The main strengths and weaknesses of the indexes, according to its design, are discussed.

Conclusion

Standardization of image acquisition protocols and patient preparation should be procured, especially for MRI. In daily practice, a simple, semi-quantitative index providing relevant information on disease activity and severity is preferable. For research purposes, a precise and reproducible index should be mandatory.