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. 2024 Aug;49(8):2913-2920.
doi: 10.1007/s00261-024-04238-3. Epub 2024 Mar 21.

Which magnetic resonance imaging feature is associated with treatment response in perianal fistulizing Crohn's disease?

Nicolas Richard  1 , Antonin Derinck  2 , Valérie Bridoux  3 , Cloé Charpentier  4 , Céline Savoye Collet  5 , Guillaume Savoye  6
Affiliations

Which magnetic resonance imaging feature is associated with treatment response in perianal fistulizing Crohn's disease?

Nicolas Richard et al. Abdom Radiol (NY). 2024 Aug.

Abstract

Purpose: Perianal fistulae are disabling complications of Crohn's Disease. Magnetic resonance imaging features could predict treatment response. This study aimed to determine which magnetic resonance imaging features were predictive of long-term clinical outcome in real life.

Methods: Consecutive patients with magnetic resonance imaging performed in a tertiary center were retrospectively analyzed. Clinical outcome was defined as a need for surgical drainage of perianal fistulae or hospitalization. Clinical data and magnetic resonance imaging features (MAGNIFI-CD and Van Assche indices, degree of fibrosis) were studied.

Results: Fifty-two patients were included between 2016 and 2019 with a mean follow-up of 38 months [29;48]. A higher MAGNIFI-CD index (17/25 versus 11/25; p < 0.01) was associated with an unfavorable long-term clinical outcome. The MAGNIFI-CD index showed an area under the curve of 0.74 (p = 0.006) to predict the clinical outcome of perianal Crohn's disease, compared to 0.67 (p < 0.05) for the Van Assche index. At a threshold of 13 for the MAGNIFI-CD index, sensitivity was 75% (CI95% [59%; 86%]) and specificity was 69% (CI95% [44%; 86%]). No association was found between the degree of fibrosis and clinical outcome, but the association of a high degree of fibrosis (≥ 80%) and of a low MAGNIFI-CD index (≤ 13) was predictive of clinical outcome (p < 0.01).

Conclusion: The MAGNIFI-CD index could be used to predict clinical outcome in perianal Crohn's disease. In combination with a high degree of fibrosis, a low MAGNIFI-CD index, may help to identify patients with the best prognosis.

Keywords: Anal fistula; Crohn’s disease; Magnetic resonance imaging; Perianal Crohn’s disease; Prognostic factor.

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References

    1. Tsai L, McCurdy JD, Ma C, Jairath V, Singh S. Epidemiology and Natural History of Perianal Crohn’s Disease: A Systematic Review and Meta-Analysis of Population-Based Cohorts. Inflamm Bowel Dis. 2022;28(10):1477-1484. doi: https://doi.org/10.1093/ibd/izab287 - DOI - PubMed
    1. Roseira J, Magro F, Fernandes S, et al. Sexual Quality of Life in Inflammatory Bowel Disease: A Multicenter, National-Level Study. Inflamm Bowel Dis. 2020;26(5):746-755. doi: https://doi.org/10.1093/ibd/izz185 - DOI - PubMed
    1. Adamina M, Bonovas S, Raine T, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Surgical Treatment. J Crohns Colitis. 2020;14(2):155-168. doi: https://doi.org/10.1093/ecco-jcc/jjz187 - DOI - PubMed
    1. Torres J, Bonovas S, Doherty G, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment. J Crohns Colitis. 2020;14(1):4-22. doi: https://doi.org/10.1093/ecco-jcc/jjz180 - DOI - PubMed
    1. Chambaz M, Verdalle-Cazes M, Desprez C, et al. Deep remission on magnetic resonance imaging impacts outcomes of perianal fistulizing Crohn’s disease. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver. 2019;51(3):358-363. doi: https://doi.org/10.1016/j.dld.2018.12.010 - DOI

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