Comparison of magnetic resonance enterography with endoscopy, histopathology, and laboratory evaluation in pediatric crohn disease

Cary G. Sauer, Jeremy P. Middleton, Adina Alazraki, Unni K. Udayasankar, Bobby T Kalb, Kimberly E. Applegate, Diego R Martin, Subra Kugathasan

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVE:: Children with Crohn disease (CD) often undergo cross-sectional imaging during clinical evaluation. Magnetic resonance enterography (MRE) is becoming the preferred radiologic assessment due to the lack of radiation exposure; however, there are few data in children with CD comparing MRE with objective disease measures. The aim of the present study was to compare MRE with endoscopy, histopathology, and laboratory evaluation in children with CD. METHODS:: We performed an institutional review board-approved query of our prospective CD MRE database, which includes data in children with CD undergoing MRE since 2008. RESULTS:: A total of 147 MRE studies were performed in 119 different children with symptomatic CD. Of those, 53 (39.6%) MRE studies were performed at diagnosis to evaluate small bowel disease burden. A total of 117 (79.6%) MRE studies displayed active and/or chronic disease, whereas 30 (20.4%) MRE studies were normal. When compared with normal MRE studies, active inflammation on MRE was associated with a higher mean C-reactive protein (3.6 vs 1.1, P<0.001), higher erythrocyte sedimentation rate (36 vs 22, P=0.0.31), higher platelet value (439 vs 352, P=0.033), and lower albumin (3.4 vs 3.7, P=0.049). Comparison between MRE and endoscopy demonstrated excellent agreement when ulcers were present, and moderate agreement with histopathology. CONCLUSIONS:: Active inflammation on MRE is associated with higher C-reactive protein, erythrocyte sedimentation rate, platelets, and lower albumin in children with CD. MRE displays excellent agreement with endoscopic disease described by ulcers but poor agreement with mild mucosal disease described by erythema and friability. The present study adds to a growing body of evidence that MRE provides excellent assessment of inflammation and measures disease activity in CD.

Original languageEnglish (US)
Pages (from-to)178-184
Number of pages7
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume55
Issue number2
DOIs
StatePublished - Aug 2012

Fingerprint

Endoscopy
Magnetic Resonance Spectroscopy
Crohn Disease
Blood Sedimentation
Pediatric Crohn's disease
Inflammation
C-Reactive Protein
Ulcer
Albumins
Blood Platelets
Research Ethics Committees
Erythema
Chronic Disease
Databases

Keywords

  • children
  • crohn disease
  • magnetic resonance enterography
  • magnetic resonance imaging
  • pediatric

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

Cite this

Comparison of magnetic resonance enterography with endoscopy, histopathology, and laboratory evaluation in pediatric crohn disease. / Sauer, Cary G.; Middleton, Jeremy P.; Alazraki, Adina; Udayasankar, Unni K.; Kalb, Bobby T; Applegate, Kimberly E.; Martin, Diego R; Kugathasan, Subra.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 55, No. 2, 08.2012, p. 178-184.

Research output: Contribution to journalArticle

Sauer, Cary G. ; Middleton, Jeremy P. ; Alazraki, Adina ; Udayasankar, Unni K. ; Kalb, Bobby T ; Applegate, Kimberly E. ; Martin, Diego R ; Kugathasan, Subra. / Comparison of magnetic resonance enterography with endoscopy, histopathology, and laboratory evaluation in pediatric crohn disease. In: Journal of Pediatric Gastroenterology and Nutrition. 2012 ; Vol. 55, No. 2. pp. 178-184.
@article{5240f77320094d2e8bb1802a89bff0d3,
title = "Comparison of magnetic resonance enterography with endoscopy, histopathology, and laboratory evaluation in pediatric crohn disease",
abstract = "BACKGROUND AND OBJECTIVE:: Children with Crohn disease (CD) often undergo cross-sectional imaging during clinical evaluation. Magnetic resonance enterography (MRE) is becoming the preferred radiologic assessment due to the lack of radiation exposure; however, there are few data in children with CD comparing MRE with objective disease measures. The aim of the present study was to compare MRE with endoscopy, histopathology, and laboratory evaluation in children with CD. METHODS:: We performed an institutional review board-approved query of our prospective CD MRE database, which includes data in children with CD undergoing MRE since 2008. RESULTS:: A total of 147 MRE studies were performed in 119 different children with symptomatic CD. Of those, 53 (39.6{\%}) MRE studies were performed at diagnosis to evaluate small bowel disease burden. A total of 117 (79.6{\%}) MRE studies displayed active and/or chronic disease, whereas 30 (20.4{\%}) MRE studies were normal. When compared with normal MRE studies, active inflammation on MRE was associated with a higher mean C-reactive protein (3.6 vs 1.1, P<0.001), higher erythrocyte sedimentation rate (36 vs 22, P=0.0.31), higher platelet value (439 vs 352, P=0.033), and lower albumin (3.4 vs 3.7, P=0.049). Comparison between MRE and endoscopy demonstrated excellent agreement when ulcers were present, and moderate agreement with histopathology. CONCLUSIONS:: Active inflammation on MRE is associated with higher C-reactive protein, erythrocyte sedimentation rate, platelets, and lower albumin in children with CD. MRE displays excellent agreement with endoscopic disease described by ulcers but poor agreement with mild mucosal disease described by erythema and friability. The present study adds to a growing body of evidence that MRE provides excellent assessment of inflammation and measures disease activity in CD.",
keywords = "children, crohn disease, magnetic resonance enterography, magnetic resonance imaging, pediatric",
author = "Sauer, {Cary G.} and Middleton, {Jeremy P.} and Adina Alazraki and Udayasankar, {Unni K.} and Kalb, {Bobby T} and Applegate, {Kimberly E.} and Martin, {Diego R} and Subra Kugathasan",
year = "2012",
month = "8",
doi = "10.1097/MPG.0b013e3182598465",
language = "English (US)",
volume = "55",
pages = "178--184",
journal = "Journal of Pediatric Gastroenterology and Nutrition",
issn = "0277-2116",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Comparison of magnetic resonance enterography with endoscopy, histopathology, and laboratory evaluation in pediatric crohn disease

AU - Sauer, Cary G.

AU - Middleton, Jeremy P.

AU - Alazraki, Adina

AU - Udayasankar, Unni K.

AU - Kalb, Bobby T

AU - Applegate, Kimberly E.

AU - Martin, Diego R

AU - Kugathasan, Subra

PY - 2012/8

Y1 - 2012/8

N2 - BACKGROUND AND OBJECTIVE:: Children with Crohn disease (CD) often undergo cross-sectional imaging during clinical evaluation. Magnetic resonance enterography (MRE) is becoming the preferred radiologic assessment due to the lack of radiation exposure; however, there are few data in children with CD comparing MRE with objective disease measures. The aim of the present study was to compare MRE with endoscopy, histopathology, and laboratory evaluation in children with CD. METHODS:: We performed an institutional review board-approved query of our prospective CD MRE database, which includes data in children with CD undergoing MRE since 2008. RESULTS:: A total of 147 MRE studies were performed in 119 different children with symptomatic CD. Of those, 53 (39.6%) MRE studies were performed at diagnosis to evaluate small bowel disease burden. A total of 117 (79.6%) MRE studies displayed active and/or chronic disease, whereas 30 (20.4%) MRE studies were normal. When compared with normal MRE studies, active inflammation on MRE was associated with a higher mean C-reactive protein (3.6 vs 1.1, P<0.001), higher erythrocyte sedimentation rate (36 vs 22, P=0.0.31), higher platelet value (439 vs 352, P=0.033), and lower albumin (3.4 vs 3.7, P=0.049). Comparison between MRE and endoscopy demonstrated excellent agreement when ulcers were present, and moderate agreement with histopathology. CONCLUSIONS:: Active inflammation on MRE is associated with higher C-reactive protein, erythrocyte sedimentation rate, platelets, and lower albumin in children with CD. MRE displays excellent agreement with endoscopic disease described by ulcers but poor agreement with mild mucosal disease described by erythema and friability. The present study adds to a growing body of evidence that MRE provides excellent assessment of inflammation and measures disease activity in CD.

AB - BACKGROUND AND OBJECTIVE:: Children with Crohn disease (CD) often undergo cross-sectional imaging during clinical evaluation. Magnetic resonance enterography (MRE) is becoming the preferred radiologic assessment due to the lack of radiation exposure; however, there are few data in children with CD comparing MRE with objective disease measures. The aim of the present study was to compare MRE with endoscopy, histopathology, and laboratory evaluation in children with CD. METHODS:: We performed an institutional review board-approved query of our prospective CD MRE database, which includes data in children with CD undergoing MRE since 2008. RESULTS:: A total of 147 MRE studies were performed in 119 different children with symptomatic CD. Of those, 53 (39.6%) MRE studies were performed at diagnosis to evaluate small bowel disease burden. A total of 117 (79.6%) MRE studies displayed active and/or chronic disease, whereas 30 (20.4%) MRE studies were normal. When compared with normal MRE studies, active inflammation on MRE was associated with a higher mean C-reactive protein (3.6 vs 1.1, P<0.001), higher erythrocyte sedimentation rate (36 vs 22, P=0.0.31), higher platelet value (439 vs 352, P=0.033), and lower albumin (3.4 vs 3.7, P=0.049). Comparison between MRE and endoscopy demonstrated excellent agreement when ulcers were present, and moderate agreement with histopathology. CONCLUSIONS:: Active inflammation on MRE is associated with higher C-reactive protein, erythrocyte sedimentation rate, platelets, and lower albumin in children with CD. MRE displays excellent agreement with endoscopic disease described by ulcers but poor agreement with mild mucosal disease described by erythema and friability. The present study adds to a growing body of evidence that MRE provides excellent assessment of inflammation and measures disease activity in CD.

KW - children

KW - crohn disease

KW - magnetic resonance enterography

KW - magnetic resonance imaging

KW - pediatric

UR - http://www.scopus.com/inward/record.url?scp=84863843565&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863843565&partnerID=8YFLogxK

U2 - 10.1097/MPG.0b013e3182598465

DO - 10.1097/MPG.0b013e3182598465

M3 - Article

VL - 55

SP - 178

EP - 184

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

SN - 0277-2116

IS - 2

ER -