Magnetic resonance enterography healing and magnetic resonance enterography remission predicts improved outcome in pediatric Crohn disease

Cary G. Sauer, Jeremy P. Middleton, Courtney McCracken, Jonathan Loewen, Kiery Braithwaite, Adina Alazraki, Diego R Martin, Subra Kugathasan

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Mucosal healing predicts clinical remission and improved outcomes in patients with Crohn disease (CD). Magnetic resonance enterography (MRE) is a noninvasive imaging modality that can assess small and large bowel wall inflammation. Evidence suggests that MRE may be an acceptable alternative to evaluate mucosal healing over endoscopy. Our objective is to determine whether MRE remission predicts clinical remission at follow-up in children with CD. Methods: We performed an institutional review board-approved retrospecitve chart review using our prospectively maintained MRE CD database. Inclusion criteria were all children who underwent an MRE more than 6 months after diagnosis with CD who had follow-up of at least 1 year from imaging. Results: A total of 101 children with CD underwent MRE, a median of 1.3 years from diagnosis with a median follow-up of 2.8 years after MRE. Active inflammation was detected in 65 MRE studies, whereas 36 MRE studies demonstrated MRE remission. A total of 88.9% of children demonstrating MRE remission were in clinical remission at follow-up, whereas only 44.6% of those demonstrating MRE active inflammation achieved clinical remission. Children demonstrating MRE-active inflammation were more likely to have a change in medication (44.6% vs 8.3%) and more likely to undergo surgery (18.5% vs 2.8%). Conclusions: MRE remission is associated with clinical remission at follow-up at least 1 year after MRE. MRE remission was associated with fewer medication changes and fewer surgeries suggesting that, similar to endoscopic remission, MRE remission demonstrates improved outcome. Additional research is needed to confirm thatMRE can be used as a surrogate for mucosal healing.

Original languageEnglish (US)
Pages (from-to)378-383
Number of pages6
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume62
Issue number3
DOIs
StatePublished - 2016

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Magnetic Resonance Spectroscopy
Crohn Disease
Inflammation
Pediatric Crohn's disease
Research Ethics Committees
Endoscopy
Databases

Keywords

  • Crohn disease
  • Magnetic resonance enterography
  • Pediatric

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

Cite this

Magnetic resonance enterography healing and magnetic resonance enterography remission predicts improved outcome in pediatric Crohn disease. / Sauer, Cary G.; Middleton, Jeremy P.; McCracken, Courtney; Loewen, Jonathan; Braithwaite, Kiery; Alazraki, Adina; Martin, Diego R; Kugathasan, Subra.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 62, No. 3, 2016, p. 378-383.

Research output: Contribution to journalArticle

Sauer, Cary G. ; Middleton, Jeremy P. ; McCracken, Courtney ; Loewen, Jonathan ; Braithwaite, Kiery ; Alazraki, Adina ; Martin, Diego R ; Kugathasan, Subra. / Magnetic resonance enterography healing and magnetic resonance enterography remission predicts improved outcome in pediatric Crohn disease. In: Journal of Pediatric Gastroenterology and Nutrition. 2016 ; Vol. 62, No. 3. pp. 378-383.
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abstract = "Background: Mucosal healing predicts clinical remission and improved outcomes in patients with Crohn disease (CD). Magnetic resonance enterography (MRE) is a noninvasive imaging modality that can assess small and large bowel wall inflammation. Evidence suggests that MRE may be an acceptable alternative to evaluate mucosal healing over endoscopy. Our objective is to determine whether MRE remission predicts clinical remission at follow-up in children with CD. Methods: We performed an institutional review board-approved retrospecitve chart review using our prospectively maintained MRE CD database. Inclusion criteria were all children who underwent an MRE more than 6 months after diagnosis with CD who had follow-up of at least 1 year from imaging. Results: A total of 101 children with CD underwent MRE, a median of 1.3 years from diagnosis with a median follow-up of 2.8 years after MRE. Active inflammation was detected in 65 MRE studies, whereas 36 MRE studies demonstrated MRE remission. A total of 88.9{\%} of children demonstrating MRE remission were in clinical remission at follow-up, whereas only 44.6{\%} of those demonstrating MRE active inflammation achieved clinical remission. Children demonstrating MRE-active inflammation were more likely to have a change in medication (44.6{\%} vs 8.3{\%}) and more likely to undergo surgery (18.5{\%} vs 2.8{\%}). Conclusions: MRE remission is associated with clinical remission at follow-up at least 1 year after MRE. MRE remission was associated with fewer medication changes and fewer surgeries suggesting that, similar to endoscopic remission, MRE remission demonstrates improved outcome. Additional research is needed to confirm thatMRE can be used as a surrogate for mucosal healing.",
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AU - Middleton, Jeremy P.

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AU - Braithwaite, Kiery

AU - Alazraki, Adina

AU - Martin, Diego R

AU - Kugathasan, Subra

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N2 - Background: Mucosal healing predicts clinical remission and improved outcomes in patients with Crohn disease (CD). Magnetic resonance enterography (MRE) is a noninvasive imaging modality that can assess small and large bowel wall inflammation. Evidence suggests that MRE may be an acceptable alternative to evaluate mucosal healing over endoscopy. Our objective is to determine whether MRE remission predicts clinical remission at follow-up in children with CD. Methods: We performed an institutional review board-approved retrospecitve chart review using our prospectively maintained MRE CD database. Inclusion criteria were all children who underwent an MRE more than 6 months after diagnosis with CD who had follow-up of at least 1 year from imaging. Results: A total of 101 children with CD underwent MRE, a median of 1.3 years from diagnosis with a median follow-up of 2.8 years after MRE. Active inflammation was detected in 65 MRE studies, whereas 36 MRE studies demonstrated MRE remission. A total of 88.9% of children demonstrating MRE remission were in clinical remission at follow-up, whereas only 44.6% of those demonstrating MRE active inflammation achieved clinical remission. Children demonstrating MRE-active inflammation were more likely to have a change in medication (44.6% vs 8.3%) and more likely to undergo surgery (18.5% vs 2.8%). Conclusions: MRE remission is associated with clinical remission at follow-up at least 1 year after MRE. MRE remission was associated with fewer medication changes and fewer surgeries suggesting that, similar to endoscopic remission, MRE remission demonstrates improved outcome. Additional research is needed to confirm thatMRE can be used as a surrogate for mucosal healing.

AB - Background: Mucosal healing predicts clinical remission and improved outcomes in patients with Crohn disease (CD). Magnetic resonance enterography (MRE) is a noninvasive imaging modality that can assess small and large bowel wall inflammation. Evidence suggests that MRE may be an acceptable alternative to evaluate mucosal healing over endoscopy. Our objective is to determine whether MRE remission predicts clinical remission at follow-up in children with CD. Methods: We performed an institutional review board-approved retrospecitve chart review using our prospectively maintained MRE CD database. Inclusion criteria were all children who underwent an MRE more than 6 months after diagnosis with CD who had follow-up of at least 1 year from imaging. Results: A total of 101 children with CD underwent MRE, a median of 1.3 years from diagnosis with a median follow-up of 2.8 years after MRE. Active inflammation was detected in 65 MRE studies, whereas 36 MRE studies demonstrated MRE remission. A total of 88.9% of children demonstrating MRE remission were in clinical remission at follow-up, whereas only 44.6% of those demonstrating MRE active inflammation achieved clinical remission. Children demonstrating MRE-active inflammation were more likely to have a change in medication (44.6% vs 8.3%) and more likely to undergo surgery (18.5% vs 2.8%). Conclusions: MRE remission is associated with clinical remission at follow-up at least 1 year after MRE. MRE remission was associated with fewer medication changes and fewer surgeries suggesting that, similar to endoscopic remission, MRE remission demonstrates improved outcome. Additional research is needed to confirm thatMRE can be used as a surrogate for mucosal healing.

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