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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Azathioprine, Child, Colon, Colonoscopy, Crohn Disease, Drug Therapy, Combination, Female, Humans, Ileum, Immunosuppressive Agents, Infliximab, Intestinal Mucosa, Logistic Models, Magnetic Resonance Imaging, Male, Prospective Studies, Sensitivity and Specificity, Treatment Outcome.
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Is baseline Wall Thickness Lower in Mucosa Healed Segments 1 Year After Infliximab in Pediatric Crohn 's Disease Patients? Context: We aimed to quantitatively investigate the therapeutic response to combined immunosuppression treatment by magnetic resonance enterography (MRE) in active luminal Crohn's disease in the pediatric population. Pediatric patients with moderate-to-severe luminal Crohn's disease who received scheduled infliximab and azathioprine were included in this preliminary study. Ileocolonoscopy and MRE were performed at baseline and at 1 year, and Simple Endoscopic Score for Crohn's Disease (SES-CD) and Magnetic Resonance Index of Activity (MaRIA) scores were calculated. The correlation between SES-CD and MaRIA scores were investigated with analysis per-person and per-segment. A total 167 segments from 17 patients were evaluated by both ileocolonoscopy and MRE. SES-CD and MaRIA scores showed significant correlations on both per-person analysis (ρ = 0.699, P < 0.001), and per-segment analysis (ρ = 0.596, P < 0.001). Analysis according to ileocolonic location of each segment revealed that correlation strength was strongest in the right colon (ρ = 0.653, P < 0.001), while the correlation in the rectum was statistically insignificant (ρ = 0.29, P = 0.096). Comparative analysis of MaRIA components revealed a significantly thinner bowel wall thickness at baseline in endoscopically healed segments (50/65) compared to unhealed segments (15/65) (median 4.3 vs. 7.2 mm, P = 0.036).
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Therapeutic response to combined immunosuppression at 1 year assessed by MRE correlates with ileocolonoscopy in pediatric patients with Crohn's disease. Bowel wall thickness of the involved segments at baseline may affect treatment response to combined immunosuppression. Final Decision: yes