Simple Enterographic Activity Score for Crohn's Disease: Comparison with endoscopic, biochemical, and clinical findings

Abstract

Introduction Magnetic resonance enterography (MRE) is believed to be a reliable diagnostic method in assessing the activity of small-bowel Crohn's disease (CD). However, there are no scales for quantifying MRE scores that could be used in everyday clinical practice. Objectives The aim of the study was to construct a simple scale for assessing the activity of CD (Simple Enterographic Activity Score for Crohn's Disease - SEAS-CD) in MRE and to investigate its clinical usefulness. Patie nts and methods We conducted a retrospective analysis of MRE findings in 122 patients with CD. Disease activity was assessed using the SEAS-CD. The reference standard was endoscopic assessment using the Simple Endoscopic Score for Crohn's Disease (SES-CD). We assessed correlations between SEAS-CD and endoscopic, clinical, and biochemical findings. We also proposed the Global Crohn's Disease Activity Score to assess total CD activity by summarizing the colonic SES-CD and SEAS-CD scores. Results In the validation group (n = 62), a significant correlation between the ileal SES-CD and ileal SEAS-CD scores was noted (r = 0.72, P <0.0001). In patients with isolated small-bowel CD, there was a significant correlation between SEAS-CD and Crohn's Disease Activity Index (CDAI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (Hb), albumin, and platelet count. In patients with ileocolonic CD, the Global Crohn's Disease Activity Score correlated with CDAI, CRP, ESR, Hb, and hematocrit. Conclusions SEAS-CD is a useful tool for the quantification of small-bowel CD activity assessed by MRE. The Global Crohn's Disease Activity Score may be useful in assessing the progression of lesions in patients with ileocolonic CD.