Dissertation - Masters Magnetic Resonance Enterography for the Assessment of Pediatric Crohn’s Disease

Author

Peter Christopher Church

Abstract

Magnetic resonance enterography (MRE) is an emerging method of assessment in Crohn’s disease (CD) and this thesis represents the first steps (item generation) in developing 2 new MRE-based, multi-item measures of inflammation and damage. Through a systematic-review and meta-analysis, 22 MRE signs used to reflect inflammation and 9 to reflect damage were discovered. The most accurate signs for inflammation were wall enhancement, mucosal lesions and wall T2 hyperintensity (most sensitivities>80% and specificities>90%), and the most accurate signs for damage were abscess and fistula (most sensitivities>90%, specificities>95%). A cross-sectional study found that among 49 patients with CD at SickKids, wall enhancement, wall T2 hyperintensity, wall thickening, and wall diffusion restriction were commonly identified and had highest sensitivity and specificity. Additionally, although not as commonly identified, mucosal lesions were also accurate. These 5 MRE signs should be included in multi-item indices for CD.


Supervisor

Brian Feldman