Derivation of a T2-weighted MRI total colonic inflammation score (TCIS) for assessment of patients with severe acute inflammatory colitis—a preliminary study
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Rehana Hafeez & Shonit Punwani & Doug Pendse & Paul Boulos & Stuart Bloom & Steve Halligan & Stuart A. Taylor
- چاپ و سال / کشور: 2010
Description
Objective To derive an MRI score for assessing severity, therapeutic response and prognosis in acute severe inflammatory colitis. Methods Twenty-one patients with acute severe colitis underwent colonic MRI after admission and again (n=16) after median 5 days of treatment. Using T2-weighted images, two radiologists in consensus graded segmental haustral loss, mesenteric and mural oedema, mural thickness, and small bowel and colonic dilatation producing a total colonic inflammatory score (TCIS, range 6–95). Preand post-treatment TCIS were compared, and correlated with CRP, stool frequency, and number of inpatient days (therapeutic response marker). Questionnaire assessment of patient worry, satisfaction and discomfort graded 1 (bad) to 7 (good) was administered Results Admission TCIS correlated significantly with CRP (Kendall’s tau=0.45, 95% confidence interval [CI] 0.11– 0.79, p=0.006), and stool frequency (Kendall’s tau 0.39, 95% CI 0.14-0.64, p=0.02). TCIS fell after treatment (median [22 range 15–31]) to median 20 [range 8–25], p=0.01. Admission TCIS but not CRP or stool frequency was correlated with length of inpatient stay (Kendall’s tau 0.40, 95% CI 0.11–0.69, p=0.02). Patients reported some discomfort (median score 4) during MRI. Conclusions MRI TCIS falls after therapy, correlates with existing markers of disease severity, and in comparison may better predict therapeutic response.
Eur Radiol (2011) 21:366–377 DOI 10.1007/s00330-010-1934-0 Received: 14 March 2010 / Revised: 19 July 2010 / Accepted: 21 July 2010 / Published online: 30 August 2010
