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Magnetic Resonance Elastography for Assessing Fibrosis in Patients with Crohn’s Disease: A Pilot Study

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Abstract

Background

Patients with Crohn’s disease can develop intestinal strictures, containing various degrees of inflammation and fibrosis. Differentiation of the main component of a stricturing lesion is the key for defining the therapeutic management.

Aims

We assessed for the first time the accuracy of magnetic resonance elastography in detecting intestinal fibrosis and predicting clinical course in patients with Crohn’s disease.

Methods

This was a prospective study of adult patients with Crohn’s disease and magnetic resonance imaging examination, including magnetic resonance elastography, between April 2019 and February 2020. The association between the bowel stiffness value and the degree of fibrosis was evaluated. The relationship between the stiffness value and the occurrence of clinical events was also investigated.

Results

A total of 69 patients were included. The stiffness value measured by magnetic resonance elastography was correlated with the degree of fibrosis (p < 0.001). A bowel stiffness ≥ 3.57 kPa predicted the occurrence of clinical events with an area under the curve of 0.82 (95% CI 0.71–0.93). Bowel stiffness ≥ 3.57 kPa was associated with an increased risk of clinical events (p < 0.0001).

Conclusion

In Crohn’s disease, magnetic resonance elastography is a reliable tool for detecting intestinal fibrosis and predicting a worse disease outcome.

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Data availability

The data underlying this article are available in the article and in its online supplementary material.

Abbreviations

CD:

Crohn’s Disease

CI:

Confidence Interval

HASTE:

Half-Fourier Single-shot Turbo spin-Echo

IBD:

Inflammatory Bowel Disease

ICC:

Intraclass Correlation Coefficient

IQR:

Interquartile Range

kPa:

Kilopascal

MRE:

Magnetic Resonance Elastography

MRI:

Magnetic Resonance Imaging

NPV:

Negative Predictive Value

PFS:

Progression-Free Survival

PPV:

Positive Predictive Value

ROC:

Receiver Operating Characteristic

ROI:

Region Of Interest

RTE:

Real-Time Elastography

SWE:

Shear-Wave Elastography

TNF:

Tumor Necrosis Factor

TrueFISP:

Fast Imaging with Steady-state free Precession

VAS:

Visual Analog Scale

VIBE:

Volumetric Interpolated Breath-hold Examination

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Author information

Author notes

  1. François Avila and Bénédicte Caron contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Radiology, University Hospital of Nancy, Vandœuvre-lès-Nancy, France

    François Avila & Valérie Laurent

  2. Department of Gastroenterology and NGERE, U1256 INSERM, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France

    Bénédicte Caron, Myriam Choukour & Laurent Peyrin-Biroulet

  3. CIC 1433 Innovation Technologique, INSERM, Université de Lorraine, , CHRU Nancy, Nancy, France

    Gabriela Hossu, Freddy Odille & Jacques Felblinger

  4. IADI, U12454, INSERM, Université de Lorraine, CHRU Nancy, Nancy, France

    Gabriela Hossu, Freddy Odille, Jacques Felblinger & Valérie Laurent

  5. Siemens Healthcare SAS, Saint Denis, France

    Khalid Ambarki

  6. MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany

    Stephan Kannengiesser

  7. Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milano, Italy

    Silvio Danese

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  1. François Avila
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  11. Laurent Peyrin-Biroulet
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Contributions

FA contributed to data collection, interpretation of data and drafting of the manuscript; BC contributed to interpretation of data and drafting of the manuscript; GH contributed to statistical analysis and interpretation of data; KA, SK contributed to data collection and interpretation of data; FO, JF, SD, MC contributed to critical review of the manuscript; VL contributed to data collection and interpretation of data; LPB contributed to study concept and design, interpretation of data and study supervision. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Laurent Peyrin-Biroulet.

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Conflict of interests

F Avila, B Caron, G Hossu, F Odille, J Felblinger, M Choukour and V Laurent declare no conflict of interest. K Ambarki and S Kannengiesser are employees of Siemens Healthcare. S Danese has served as a speaker, consultant and advisory board member for Schering-Plough, AbbVie, Actelion, Alphawasserman, AstraZeneca, Cellerix, Cosmo Pharmaceuticals, Ferring, Genentech, Grunenthal, Johnson and Johnson, Millenium Takeda, MSD, Nikkiso Europe GmbH, Novo Nordisk, Nycomed, Pfizer, Pharmacosmos, UCB Pharma and Vifor. L Peyrin-Biroulet has served as a speaker, consultant and advisory board member for Merck, Abbvie, Janssen, Genentech, Mitsubishi, Ferring, Norgine, Tillots, Vifor, Hospira/Pfizer, Celltrion, Takeda, Biogaran, Boerhinger-Ingelheim, Lilly, HAC- Pharma, Index Pharmaceuticals, Amgen, Sandoz, For- ward Pharma GmbH, Celgene, Biogen, Lycera, Samsung Bioepis, Theravance.

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Avila, F., Caron, B., Hossu, G. et al. Magnetic Resonance Elastography for Assessing Fibrosis in Patients with Crohn’s Disease: A Pilot Study. Dig Dis Sci 67, 4518–4524 (2022). https://doi.org/10.1007/s10620-021-07311-9

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  • DOI: https://doi.org/10.1007/s10620-021-07311-9

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