Crohn disease: magnetic resonance enterocolonography features of endoscopic ulcer stages reclassified with the healing process and the relationships to prognoses.

Abstract

This study aimed to compare magnetic resonance enterocolonography (MREC) features among the endoscopic ulcer stages reclassified to include healing ulcers and to assess the prognoses in Crohn disease (CD). Altogether, 89 consecutive patients with CD who had undergone MREC and ileocolonoscopy or balloon-assisted enteroscopy were retrospectively studied. Patients were reclassified into 38 patients with no deep ulcer, seven with healing deep ulcer, and 44 with active deep ulcer stage. MREC score derived from a 5-point MR classification and MR index of activity (MaRIA) were evaluated, and patients were followed-up. The primary endpoint was hospitalization. Healing deep ulcers had higher values in MREC score and MaRIA than no deep ulcers (p < 0.001), and lower values than active deep ulcers (p < 0.001). The 5-year cumulative rates of hospitalization for no deep ulcer, healing deep ulcer, and active deep ulcers were 24.9, 0, and 52.4% (p < 0.05), respectively. MREC score or MaRIA-positive patients had a higher 5-year cumulative rate of hospitalization than the negative patients (p < 0.01 and p < 0.05, respectively). MREC could reflect the healing stages, and the identification was revealed to be important because of the good prognosis. MREC might be useful to predict prognosis of CD.