Inflammatory Bowel Diseases Clinical Trial
Official title:
Role of Magnetic Resonance Enterography (MRE) in Assessment of Inflammatory Bowel Diseases.
Assess the accuracy of magnetic resonance-enterography in predicting the extension, location and characteristics of the small bowel segments affected by Crohn's disease& determine the diagnostic performance of standard MR enterography in detecting colonic inflammation and investigate MR enterography's ability to grade inflammatory activity and detect intestinal extra intestinal manifestations
Inflammatory bowel diseases (IBD) are chronic disorders of the gastrointestinal tract with a
remitting-relapsing disease pattern. Ulcerative colitis (UC) and Crohn's disease (CD)
represent the two main forms of IBD.
In CD inflammation affects various parts of the bowel, separated by unchanged intestinal
segments, while in ulcerative colitis enteric involvement is continuous, extending from the
rectum throughout the colon. Additionally, in Crohn's disease the inflammatory process
spreads through all layers of the intestinal wall, while in UC only the mucosa and sub mucosa
are affected.
Imaging findings, endoscopic studies and histological data together with clinical assessment,
can be used to help distinguish these two forms, determine prognosis, assess disease activity
and to inform treatment decision-making.
A "treat-to-target" strategy with close monitoring of intestinal inflammation is recommended
in inflammatory bowel disease (IBD). Ileocolonoscopy (CS) remains the gold-standard for
assessing disease activity in IBD but is a relatively invasive procedure and is impossible to
repeat in the context of tight monitoring strategies.
MRE is preferred over computed tomography enterography by most radiologists and
gastroenterologists because of the potential for differentiating active inflammation from
fibrotic strictures, and due to the lack of exposure to ionizing radiation. This is
especially true in children, as the onset of IBD in childhood is a known risk factor for high
cumulative exposure to ionizing radiation from imaging.
MRE furthermore provides a transmural study of bowel loops (oedema, wall thickening, and
enhancement post contrast). These features make MRE ideally suitable to the IBD population.
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