Dig Dis Sci. 2022 Jun;67(6):2462-2470. doi: 10.1007/s10620-021-07016-z. Epub 2021 Jun 22.

Aurélie Grandmougin ^# 1, Ferdinando D'Amico ^# 2 3, Thomas Remen ⁴, Silvio Danese ^2 5, Marjorie Bonneton ⁶, Marie Agnes Galloy ⁷, Laurent Peyrin-Biroulet ³, Valérie Laurent ⁸

Author information

¹Department of Radiology, Nancy University Hospital, Lorraine University, 1 Allée du Morvan, 54511, Vandoeuvre-lès-Nancy, France.

²Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

³Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France.

⁴Methodology, Data Management and Statistic Unit, MPI Department, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.

⁵IBD Center, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy.

⁶Department of Pediatric Gastroenterology, Hepatology and Nutrition, Childrens Hospital of Nancy, Vandoeuvre-le`s-Nancy, France.

⁷Department of Pediatric Radiology, Childrens University Hospital, Nancy, France.

⁸Department of Radiology, Nancy University Hospital, Lorraine University, 1 Allée du Morvan, 54511, Vandoeuvre-lès-Nancy, France. v_croiselaurent@yahoo.fr.

^#Contributed equally.

Abstract

Background: The association between radiological remission and natural history of disease in children with inflammatory bowel diseases (IBD) is poorly known.

Aims: (i) To assess the correlation between cross-sectional imaging (CSI) (ultrasound and magnetic resonance imaging) and clinical, biomarker and endoscopic disease activity; (ii) to evaluate the impact of radiological activity on the occurrence of complications in pediatric patients with IBD.

Methods: A retrospective study including pediatric patients with IBD and radiological follow-up of at least one year was conducted between 2003 and 2019 at the Nancy University Hospital.

Results: In total, 118 patients (66 Crohn's disease (CD) and 52 ulcerative colitis (UC)) were included. Median follow-up duration was 5.2 years (range: 1.1-15.4). Seventeen (25.8%) patients with CD and 7 (13.5%) patients with UC achieved and maintained radiological remission until last follow-up. No IBD patient achieving radiological remission experienced complications or relapse. In patients not achieving radiologic remission, complications and surgery occurred in 13/49 (26.5%) and 8/49 (16.3%) patients with CD and in 5/45 (11.1%) and 5 (11.1%) subjects with UC. Among patients with CD, the association for remission status between radiological and endoscopic assessment was excellent (Cramer's V test (V) = 0.50), and moderate between radiological and either clinical (V = 0.30) or biochemical (V = 0.33) assessments. In UC, the association for remission status between radiological and either endoscopic or clinical assessments were weak (V = 0.19 and V = 0.20 respectively), and moderate (V = 0.23) between radiological and biochemical assessments.

Conclusion: CSI may replace endoscopic monitoring in pediatric CD. Radiological remission status predicts long-term disease outcomes.