Dynamic MRI with mapping of T1-values as indicators of disease activity in luminal Crohn’s disease.

Crohn’s disease (CD) is a transmural inflammatory bowel disease. Grading of severity of disease is important to be able to optimally determine treatment strategy and response to treatment. Abdominal MR-imaging using luminal and intravenous contrast medium combines transmural and extra-intestinal evaluation and can accurately show presence of disease.

The marked increase in signal intensity of inflammatory on contrast-enhanced fat saturated T1-weighted sequences can be seen due to increased tissue perfusion and vascular permeability. Analysis of the time-dependent changes of signal intensity after administration of contrast medium by DCE-MRI can add valuable information about disease activity in Crohn’s disease as the kinetic of the signal variation reflects the status of tissue microcirculation.
Hypothetically, calculation of the absolute T1-values in tissue before and after intravenous injection of Gadolinium would provide objective measurements of the Gadolinium-uptake. This so-called T1-mapping in abdominal MRI could indeed be used to determine activity of disease in an objective, quantifiable, reproducible manner and could be a valuable tool to the present imperfect disease scores such as CDAI (Crohn’s Disease Activity Index), CDEIS and CRP.


Objective:

To test the accuracy of dynamic MRI with T1 mapping in patients with CD and compare this with know parameters such as CDEIS, CRP and CDAI.


Study design:

A prospective observational feasibility study. Patients will undergo the clinically planned ileocolonoscopy, a MRI scan, and fill out the PDAI and a standardized questionnaire to score the burden of both tests.


Study population:

Thirty patients with proven Crohn’s disease (by endoscopy and/or histopathology) who are scheduled to undergo ileocolonoscopy as part of their clinical follow-up will be included.

To test the accuracy of dynamic MRI with T1 mapping in patients with CD and compare this with know parameters such as CDEIS, CRP and CDAI.

Patients will undergo the ileocolonoscopy and the MRI will be planned before or after.

Longer MRI scan due to extra dynamic sequence.