Original ResearchFull Report: Clinical—Alimentary TractDevelopment and Validation of a Simplified Magnetic Resonance Index of Activity for Crohn’s Disease
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Section snippets
Patients and Examinations
MR data from 98 patients with an established diagnosis of CD, with or without clinical symptoms of activity, from 2 prospective studies were reanalyzed. Endoscopic and MR examinations of these 2 series were used to develop the MARIAs using endoscopy (CD endoscopic index of severity [CDEIS]) as reference standard.7, 11 All patients underwent both examinations within 2 days. Further analysis of responsiveness and reliability of the resulting simplified index was performed using an independent
Derivation of the MARIAs
For derivation of the MARIAs, data from 98 MRs of patients with CD were analyzed, representing a total of 588 segments, of which 495 were evaluated by both MR and endoscopy (terminal ileum n = 96, colonic segments = 399). Of these, 210 segments were categorized as having active disease by endoscopy (42.3%), of which 65 had mild-moderate activity (13.1%) and 145 (29.1%) had severe lesions (ulcers).
Prevalence of segmental qualitative MR findings according to endoscopic severity of lesions is
Discussion
The MARIA is one of the best characterized MR-based indices for assessing disease activity and grading severity in patients with CD and has been proposed as a tool for monitoring disease activity in clinical practice and clinical trials. The index has proven to have a substantial intra- and interrater reliability,23 but calculation of the index requires training, and measuring some components is time-consuming, in particular RCE, which requires measurements in 3 regions of interest in each
Acknowledgments
Author contributions: Ingrid Ordás: study design and study coordination, acquisition of endoscopic data, statistical analysis and interpretation of data, manuscript writing, critical revision and approval of the final draft submitted; Jordi Rimola: acquisition of data, interpretation of magnetic resonance imaging procedures, revision of the manuscript, and approval of the final draft submitted; Ignacio Alfaro: acquisition of data and approval of the final draft submitted; Sonia Rodríguez:
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Conflicts of interest The authors disclose the following: I.O. has received consulting fees from AbbVie, unrestricted research grants from Faes Pharma and AbbVie; J.R. has received consulting fees from Robarts Clinical Trials, TiGenix, and Takeda, unrestricted research grants from AbbVie and Genentech; E.R. has received consulting fees from AbbVie, MSD, Jansen, and Takeda; J.P. has received consulting fees from AbbVie, Arena, Boehringer Ingelheim, Celgene, GoodGut, GSK, Janssen, MSD, Nestlé, Oppilan, Pfizer, Takeda, Theravance, and TiGenix, and unrestricted research grants from AbbVie and MSD. The remaining authors disclose no conflicts.
Funding This work was supported by unrestricted grants from Fondos de Investigación Sanitaria (FIS), Instituto de Salud Carlos III (PI07/90253 and PI10/01170), ECCO Grant 15/173, GETECCU Faes Farma, and AbbVie Laboratories.