BACKGROUND AND AIMS Gadolinium-enhanced sequences are not included in the simplified Magnetic Resonance Index of Activity (sMARIA), but in the derivation of this index readers had access to these sequences. The current study aimed to validate the sMARIA without gadolinium-enhanced sequences for assessing disease activity, severity, and response to treatment in patients with Crohn's disease. PATIENTS AND METHODS We prospectively included patients with active Crohn's disease and at least one segment with severe inflammation (ulcers) at ileocolonoscopy who required treatment with biological drugs. Patients were evaluated by both MRE and ileocolonoscopy at baseline and 46 weeks after initiation of medical treatment. We compared the quantification of disease activity and response to treatment with sMARIA versus with ileocolonoscopy (CDEIS), considered the gold standard. RESULTS Data from both MRE and ileocolonoscopy 46 weeks after treatment initiation were available for 39 of the 50 patients. As in the derivation study, the optimal cutoffs were sMARIA≥1 for predicting active disease (area under the curve [AUC] 0.92) and sMARIA≥2 for predicting the presence of ulcers at ileocolonoscopy (AUC 0.93). In evaluating the response to treatment, the sMARIA detected endoscopic ulcer healing at the segment level (sMARIA<2) with 89.5% sensitivity and 87.5% specificity. The sMARIA decreased significantly (p<0.001) in segments achieving endoscopic ulcer healing, but did not change (p=0.222) in segments with persistent ulceration.

中文翻译：

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不含d增强序列的克罗恩病活动的简化磁共振指数[sMARIA]的验证。

背景和目的Ga增强的序列不包括在简化的磁共振活动指数（sMARIA）中，但是在该指数的推论中，读者可以使用这些序列。当前的研究旨在验证无g增强序列的sMARIA，以评估克罗恩病患者的疾病活性，严重性和对治疗的反应。患者与方法我们的研究对象包括活动性克罗恩病患者和至少一部分在回肠结肠镜检查中有严重炎症（溃疡）的患者，这些患者需要用生物药物治疗。在开始治疗和开始治疗后46周，通过MRE和结肠镜检查对患者进行评估。我们比较了sMARIA和回肠结肠镜检查（CDEIS）对疾病活动和对治疗的反应的量化，被认为是黄金标准。结果50例患者中有39例在治疗开始后46周来自MRE和回肠结肠镜检查。如同在衍生研究中一样，用于预测活动性疾病的最佳阈值是sMARIA≥1（曲线下面积[AUC] 0.92），用于在结肠结肠镜检查中预测溃疡的存在的最佳阈值是sMARIA≥2（AUC 0.93）。在评估对治疗的反应时，sMARIA在段水平（sMARIA <2）上以89.5％的敏感性和87.5％的特异性检测到内镜溃疡愈合。在实现内镜溃疡愈合的节段中，sMARIA显着降低（p <0.001），而在持续性溃疡节段中，sMARIA没有改变（p = 0.222）。如在衍生研究中一样，用于预测活动性疾病的最佳阈值是sMARIA≥1（曲线下面积[AUC] 0.92），用于在结肠结肠镜检查中预测溃疡存在的最佳阈值是sMARIA≥2（AUC 0.93）。在评估对治疗的反应时，sMARIA在段水平（sMARIA <2）上以89.5％的敏感性和87.5％的特异性检测到内镜溃疡愈合。在实现内镜溃疡愈合的节段中，sMARIA显着降低（p <0.001），而在持续性溃疡节段中，sMARIA没有改变（p = 0.222）。如在衍生研究中一样，用于预测活动性疾病的最佳阈值是sMARIA≥1（曲线下面积[AUC] 0.92），用于在结肠结肠镜检查中预测溃疡存在的最佳阈值是sMARIA≥2（AUC 0.93）。在评估对治疗的反应时，sMARIA在段水平（sMARIA <2）上以89.5％的敏感性和87.5％的特异性检测到内镜溃疡愈合。在实现内镜溃疡愈合的节段中，sMARIA显着降低（p <0.001），而在持续性溃疡节段中，sMARIA没有改变（p = 0.222）。2）灵敏度为89.5％，特异性为87.5％。在实现内镜溃疡愈合的节段中，sMARIA显着降低（p <0.001），而在持续性溃疡节段中，sMARIA没有改变（p = 0.222）。2）灵敏度为89.5％，特异性为87.5％。在实现内镜溃疡愈合的节段中，sMARIA显着降低（p <0.001），而在持续性溃疡节段中，sMARIA没有改变（p = 0.222）。