Magnetically Guided Capsule Endoscopy and Magnetic Resonance Enterography in Children With Crohn's Disease: Manifestations and the Value of Assessing Disease Activity

Jia Li; Xuesong Zhao; Wen Su; Ruizhe Shen; Yuan Xiao; Xinqiong Wang; Xu Xu; Chundi Xu; Na Li; Yi Yu

doi:10.3389/fphar.2022.894808

Magnetically Guided Capsule Endoscopy and Magnetic Resonance Enterography in Children With Crohn's Disease: Manifestations and the Value of Assessing Disease Activity

Front Pharmacol. 2022 Apr 27:13:894808. doi: 10.3389/fphar.2022.894808. eCollection 2022.

Authors

Jia Li¹, Xuesong Zhao², Wen Su¹, Ruizhe Shen³, Yuan Xiao¹, Xinqiong Wang¹, Xu Xu¹, Chundi Xu¹, Na Li^{1

4}, Yi Yu¹

Affiliations

¹ Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Digestive Endoscopy Center, Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁴ School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, China.

Abstract

Objective: To investigate the value of magnetically guided capsule endoscopy (MGCE) and magnetic resonance enterography (MRE) in assessing the activity of pediatric Crohn's disease. Methods: Clinical data from 82 subjects with pediatric Crohn's disease, who underwent MGCE and MRE from October 2018 to March 2021 were analyzed retrospectively. Pairwise comparisons of several indexes, including MaRIA, CECDAI, PCDAI, and SES-CD, were performed by Spearman's rank correlation test and kappa consistency analysis. CECDAI and MaRIA values predicted whether patients were moderately or severely active (PCDAI ≥30) clinically by logistic regression analysis. The area under the receiver operating characteristic curve (AUC) quantified the evaluation value of moderate to severe activity of pediatric CD. Results: In judging the severity of CD in the small intestine, the correlation coefficient between CECDAI and MaRIA was 0.406 (p < 0.05), and the kappa value of the consistency analysis was 0.299 (p < 0.05). MaRIA was weakly correlated with PCDAI (r = 0.254, p < 0.05), and they were weakly consistent in assessing the activity of Crohn's disease (kappa = 0.135, p < 0.05). For predicting clinically moderate to severe activity, the fitted AUC based on CECDAI and MarRIA was 0.917, which was higher than applying a single parameter (CECDAI = 0.725, MarRIA = 0.899, respectively). MaRIA and serum albumin were significantly and negatively correlated (r = -1.064, p < 0.05). The consistency of the detection rate of gastric ulcers by MGCE and gastroscopy was moderate (kappa = 0.586, p < 0.05), and the detection rate of ulcers in the terminal ileum between MGCE and colonoscopy showed high consistency (kappa = 0.609, p < 0.05). Conclusions: MGCE and MRE are valuable, non-invasive methods for evaluating small bowel lesions in children with CD. The combined application of MGCE and MRE can better characterize the disease activity.

Keywords: Crohn’s disease; laboratory markers; magnetic resonance enterography; magnetically guided capsule endoscopy; pediatric Crohn’s disease activity index; pediatric patients.