Is this common IBD classification system inaccurate?

  • Maccioni F & al.
  • Eur Radiol
  • 7 Feb 2019

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Children with Crohn’s disease have more rectal involvement and perianal disease compared with adults, based on this MRI study.
  • Authors also note “apparent inaccuracy of the Montreal clinical classification” that their results suggest.

Why this matters

  • The pediatric distinctions imply worse outcomes for these patients, say the authors.
  • Clinicians may want to consider these differential imaging manifestations.

Key results

  • Perianal disease prevalence:
    • 34.6% among children.
    • 16.1% among adults.
    • OR for children: 2.8 (P=.0018).
  • Rectal involvement prevalence:
    • 29.7% among children.
    • 13.5% among adults.
    • OR for children, 2.7 (P=.0042).
  • Children had a higher risk for perianal involvement with rectal disease (OR, 4.5; P=.0286).
  • Applying the Montreal classification for lesion location failed to surface these differences.

Study design

  • Retrospective review, 219 MRI studies included (118 adults; 101 children), 2013-2016.
  • Fisher’s exact and ORs calculated.
  • Funding: None. 

Limitations

  • Retrospective, single-center.

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