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Crohn Disease: HELP
Articles by Francesca Maccioni
Based on 10 articles published since 2010
(Why 10 articles?)

Between 2010 and 2020, F. Maccioni wrote the following 10 articles about Crohn Disease.
+ Citations + Abstracts
1 Editorial Introduction to the feature section on "Crohn's disease activity: MRI assessment and clinical implications". 2012

Maccioni, Francesca. · ·Abdom Imaging · Pubmed #22527154.

ABSTRACT: -- No abstract --

2 Review Hybrid imaging in Crohn's disease: from SPECT/CT to PET/MR and new image interpretation criteria. 2018

Catalano, Onofrio / Maccioni, Francesca / Lauri, Chiara / Auletta, Sveva / Dierckx, Rudi / Signore, Alberto. ·Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center, Groningen, The Netherlands. · Department of Radiological Sciences, Oncology and Pathology, Umberto I Hospital, Sapienza University Rome, Rome, Italy. · Unit of Nuclear Medicine, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy. · Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center, Groningen, The Netherlands - sveva.auletta@hotmail.it. ·Q J Nucl Med Mol Imaging · Pubmed #29191001.

ABSTRACT: Crohn's disease is a chronic relapsing disease characterized by mucosal inflammation, lymphocytes infiltration and fibrotic strictures. Usually, the assessment of location, extension, inflammatory activity and severity of intestinal lesions is complex and invasive with endoscopic methods or histological and biochemical investigations. Thus, the diagnosis remains a challenge for the management of patients. Nuclear medicine techniques, in particular hybrid and molecular imaging, might offer a valid option for the evaluation and determination of the prognosis of the disease. Indeed, imaging methods provide a non-invasive, reproducible and quantitative analysis. An overview of the currently available multimodality imaging techniques in Crohn's disease are reviewed, with particular regard to positron-emission tomography/magnetic resonance and the choice of the best evaluation Score, explaining advantages and disadvantages of each one, with particular regard to their potential role for the assessment of disease activity and extent of inflammation in order to improve the diagnosis. We propose new interpretation criteria for PET/MR images.

3 Review New frontiers of MRI in Crohn's disease: motility imaging, diffusion-weighted imaging, perfusion MRI, MR spectroscopy, molecular imaging, and hybrid imaging (PET/MRI). 2012

Maccioni, Francesca / Patak, Michael A / Signore, Alberto / Laghi, Andrea. ·Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy. francesca.maccioni@uniroma1.it ·Abdom Imaging · Pubmed #22743838.

ABSTRACT: This article reviews the latest diagnostic advances in the evaluation of the CD, including functional studies on intestinal motility and molecular characterization of the inflammatory process at the level of the involved bowel. Molecular changes related to inflammation of the intestinal wall may be evaluated by different MRI techniques, including diffusion-weighted imaging, perfusion weighted imaging, in vivo spectroscopy, molecular imaging, and fusion imaging (PET-MRI).

4 Review Value of T2-weighted magnetic resonance imaging in the assessment of wall inflammation and fibrosis in Crohn's disease. 2012

Maccioni, F / Staltari, I / Pino, A R / Tiberti, A. ·Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, University Sapienza of Rome, Viale Regina Elena 324, 00161 Rome, RM, Italy. francesca.maccioni@uniroma1.it ·Abdom Imaging · Pubmed #22639331.

ABSTRACT: This review focuses specifically on the diagnostic value of T2-weighted imaging in the assessment of Crohn's disease (CD) inflammation. In general, T2-weighted imaging has been less extensively investigated than T1-weighted gadolinium-enhanced imaging, even if it may offer similar information on disease activity. Furthermore, T2-weighted imaging allows CD characterization, which is crucial in the management of the disease when differentiating intestinal edema from fibrosis. Technical aspects, morphological findings and signs of active intestinal inflammation and fibrosis detectable on T2-weighted images will be reviewed and shown. Correlation between T2-weighted imaging findings, clinical activity indexes and histopathology features will be discussed. Since T2-weighted imaging is essential in the evaluation of CD activity, it should always complement with T1-weighted imaging, although it could also be used alone in the assessment of CD.

5 Review Imaging of cell trafficking in Crohn's disease. 2010

Glaudemans, Andor W J M / Maccioni, Francesca / Mansi, Luigi / Dierckx, Rudi A J O / Signore, Alberto. ·Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, the Netherlands. ·J Cell Physiol · Pubmed #20175112.

ABSTRACT: Inflammatory bowel diseases are represented by ulcerative colitis and Crohn's disease, both consisting of a chronic, uncontrolled inflammation of the intestinal mucosa of any part of the gastrointestinal tract with patchy or continuous inflammation. Ileo-colonoscopy is considered the current gold standard imaging technique for the diagnosis. However, as the majority of patients need a long-term follow-up it would be ideal to rely on a non-invasive technique with good compliance. This review focuses on nuclear medicine imaging techniques in Crohn's disease. Different scintigraphic methods of imaging cells involved in the pathogenesis are described. The radiopharmaceuticals can be divided into non-specific radiopharmaceuticals for inflammation and specific radiopharmaceuticals that directly image lymphocytes involved in the process. This non-invasive molecular imaging approach can be useful also because it images the small bowel or other areas--where colonoscopy is not useful-and that it may play a role for constant follow-up, because relapses are frequent. Finally, an update on other imaging modalities, and particularly MRI, in the evaluation of Crohn's disease activity, is provided. Although MRI cannot directly detect inflammatory cells, it has shown a high sensitivity in detecting the macroscopic signs of inflammation at the level of the intestinal wall affected by Crohn's disease and Ulcerative colitis. The current diagnostic value of MRI in the detection of inflamed bowel segment and in the assessment of CD activity, as well the potentials MR spectroscopy, MR diffusion imaging and MR molecular imaging, is briefly discussed.

6 Article MRI reveals different Crohn's disease phenotypes in children and adults. 2019

Maccioni, Francesca / Bencardino, Davide / Buonocore, Valeria / Mazzamurro, Fabrizio / Viola, Franca / Oliva, Salvatore / Vernia, Piero / Merli, Manuela / Vestri, Anna Rita / Catalano, Carlo / Cucchiara, Salvatore. ·Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Policlinico Umberto I Hospital , Viale del Policlinico, 155, 00161, Rome, Italy. francesca.maccioni@uniroma1.it. · Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Policlinico Umberto I Hospital , Viale del Policlinico, 155, 00161, Rome, Italy. · Department of Pediatrics and Pediatric Neuropsychiatry, Sapienza University of Rome, Policlinico Umberto I Hospital, Viale del Policlinico, 155, 00161, Rome, Italy. · Department of Internal Medicine and Medical Specialties, Gastroenterology Unit, Sapienza University of Rome, Policlinico Umberto I Hospital, Viale del Policlinico, 155, 00161, Rome, Italy. · Gastroenterology, Department of Clinical Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Viale del Policlinico, 155, 00161, Rome, Italy. · Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy. ·Eur Radiol · Pubmed #30729332.

ABSTRACT: OBJECTIVES: To identify differences between two cohorts of adult and pediatric patients affected by Crohn's disease (CD), with regard to lesion location in the small intestine and colon-rectum, lesion activity, and prevalence of perianal disease (PD), using MRI as the main diagnostic tool. METHODS: We retrospectively reviewed 350 consecutive MRI examinations performed between 2013 and 2016 in outpatients or inpatients with histologically proven CD, monitored by the Gastroenterology and Pediatric Units of our Hospital. The magnetic resonance enterography (MRE) protocol for adult and pediatric CD patients routinely includes evaluation of nine different intestinal segments (from jejunum to rectum) and of the anal canal. Intestinal activity was also calculated using a validated score. Perianal disease (PD) was staged. Fisher's exact test was used and the odds ratio (OR) was calculated. RESULTS: Two hundred and nineteen out of 350 MRI studies (118 adults and 101 children) were included. The prevalence of PD was 34.6% in children and 16.1% in adults (OR = 2.8; p = 0.0017). Pediatric patients showed more frequent rectal involvement (29.7% vs 13.5%, OR = 2.7; p = 0.0045) and higher risk of PD in the presence of rectal disease (p = 0.043; OR = 4.5). In pediatric patients with severe colorectal disease, the prevalence of PD was twofold (86.7% vs 40%; p = 0.072). Using the clinical Montreal classification for lesion location, no significant differences emerged between the two patient populations. CONCLUSIONS: MRI showed a significantly higher prevalence of rectal involvement and perianal disease in the pediatric population. These results may have a relevant clinical impact and deserve further investigation. KEY POINTS: • To our knowledge, this is the largest morphological comparative study available in the literature using MRI as the main diagnostic tool to compare adult patients and children with Crohn's disease. • Our study showed significant differences between adults and children: a higher prevalence of rectal and perianal fistulous disease (PD) in pediatric patients and an increased prevalence of PD in the presence of severe colon-rectum involvement. • The association of rectal and perianal disease implies a poorer clinical prognosis and a higher risk of disabling complications in pediatric patients.

7 Article Magnetic resonance enterography, small-intestine contrast US, and capsule endoscopy to evaluate the small bowel in pediatric Crohn's disease: a prospective, blinded, comparison study. 2015

Aloi, Marina / Di Nardo, Giovanni / Romano, Giusy / Casciani, Emanuele / Civitelli, Fortunata / Oliva, Salvatore / Viola, Franca / Maccioni, Francesca / Gualdi, Gianfranco / Cucchiara, Salvatore. ·Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy. · Radiology DEA, Sapienza University of Rome, Rome, Italy. · Radiologic, Oncologic and Anatomophatological Sciences, Sapienza University of Rome, Rome, Italy. ·Gastrointest Endosc · Pubmed #25115363.

ABSTRACT: BACKGROUND: Small-bowel (SB) disease is a severe clinical entity among the phenotypes of Crohn's disease (CD). OBJECTIVE: To assess sensitivity, specificity, and accuracy of magnetic resonance enterography (MRE), small-intestine contrast US (SICUS), and capsule endoscopy (CE) in the diagnosis of pediatric SB-CD. DESIGN: Prospective, blinded, comparison study. SETTING: Tertiary center for pediatric inflammatory bowel disease. PATIENTS: Children with known or suspected CD. Diagnosis of SB obstruction at SICUS or MRE excluded patients from the study. INTERVENTION: Patients underwent ileocolonoscopy, MRE, SICUS, and CE over a 7-day period. For the imaging evaluation, SB was divided into 3 segments: jejunum, proximal and mid ileum, and terminal ileum. MAIN OUTCOME MEASUREMENTS: The performance of each method was compared to a consensus reference standard for upper SB and to ileocolonoscopy for the terminal ileum. RESULTS: Twenty-five patients completed the study. In the jejunum, the sensitivity of SICUS and CE was 92%, which was not significantly higher than MRE (75%); the specificity of CE (61%) was significantly lower than that of MRE (P = .04). In the proximal and mid ileum, MRE and CE did not have significantly higher sensitivity (100%) than SICUS (80%), but CE was less specific (P > .05). At the terminal ileum, SICUS and MRE were slightly more sensitive than CE (94% vs. 81%); however, the latter was more specific. LIMITATIONS: Use of the consensus reference standard for upper SB. Small number of patients. CONCLUSION: SICUS, MRE, and CE are all effective options for imaging SB. An integrated use of different tools should be suggested to achieve a complete assessment of the SB in children with suspected or confirmed CD.

8 Article Detection of Crohn disease lesions of the small and large bowel in pediatric patients: diagnostic value of MR enterography versus reference examinations. 2014

Maccioni, Francesca / Al Ansari, Najwa / Mazzamurro, Fabrizio / Civitelli, Fortunata / Viola, Franca / Cucchiara, Salvatore / Catalano, Carlo. ·1 Department of Radiological Sciences, Oncology, and Pathology, Sapienza University of Rome, Policlinico Umberto I Hospital, Viale Regina Elena 324, Rome 00161, Italy. ·AJR Am J Roentgenol · Pubmed #25341168.

ABSTRACT: OBJECTIVE: The purpose of this article is to prospectively determine the accuracy of MR enterography in detecting Crohn disease lesions from the jejunum to the anorectal region in pediatric patients, in comparison with main reference investigations. SUBJECTS AND METHODS: Fifty consecutive children with known Crohn disease underwent MR enterography with oral contrast agent and gadolinium-chelate intravenous injection. Two radiologists detected and localized lesions by dividing the bowel into nine segments (450 analyzed segments in 50 patients). Ileocolonoscopy, barium studies, intestinal ultrasound, and capsule endoscopy were considered as first- and second-level reference examinations and were performed within 15 days of MR enterography. RESULTS: MR enterography detected lesions in 164 of 450 segments, with 155 true-positive and nine false-positive findings; overall sensitivity, specificity, and positive and negative predictive values for small- and large-bowel lesions were 94.5%, 97%, 94.5%, and 97%, respectively (ĸ = 0.93; 95% CI, 0.89-0.97). Sensitivity and specificity values were 88% and 97%, respectively, for the jejunum, 100% and 97% for the proximal-to-mid ileum, 100% and 100% for the distal ileum, 93% and 100% for the cecum, 70% and 97% for the ascending colon, 80% and 100% for the transverse colon, 100% and 92% for the descending colon, 96% and 90% for the sigmoid colon, and 96% and 88% for the rectum. From jejunum to rectum, the AUC value ranged between 0.916 (jejunum) and 1.00 (distal ileum). Perianal fistulas were diagnosed in 15 patients, and other complications were found in 13 patients. CONCLUSION: MR enterography showed an accuracy comparable to that of reference investigations, for both small- and large-bowel lesions. Because MR enterography is safer and more comprehensive than the reference examinations, it should be considered the primary examination for detecting Crohn disease lesions in children.

9 Article Differences in the location and activity of intestinal Crohn's disease lesions between adult and paediatric patients detected with MRI. 2012

Maccioni, Francesca / Viola, Franca / Carrozzo, Federica / Di Nardo, Giovanni / Pino, Anna Rosaria / Staltari, Ilaria / Al Ansari, Najwa / Vestri, Annarita / Signore, Alberto / Marini, Mario / Cucchiara, Salvatore. ·Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University, Viale Regina Elena 324, 00161, Rome, Italy. francesca.maccioni@uniroma1.it ·Eur Radiol · Pubmed #22926159.

ABSTRACT: OBJECTIVES: To prospectively compare paediatric patients (PP) and adult patients (AP) affected by Crohn's disease (CD) in terms of the location and activity of intestinal lesions. METHODS: Forty-three children (mean age 15 years) and 43 adults (mean age 48 years) with proven CD underwent magnetic resonance enterography (MRE) to localise lesions and detect their activity in 9 segments of the small and large bowel. The results were analysed on a per patient and per segment basis. Ileo-colonoscopy was performed in all patients. P values less than 0.05 were considered statistically significant. RESULTS: Involvement of terminal ileum was significantly different in the two groups: observed in 100 % of AP (43/43) versus 58 % (23/43) of PP (P < 0.0001). Conversely, the colon was diseased in 84 % of PP versus 64 % of AP. In particular, left colonic segments were significantly more involved in PP (descending colon 53 % versus 21 %, P < 0.01; rectum 67 % versus 23 %, P < 0.0001; sigmoid colon 56 % versus 37 %, not significant), whereas caecal involvement was equal in both groups. In children the maximal disease activity was found in left colonic segments, whereas in adults it was in the terminal ileum. CONCLUSIONS: MRE detected significant differences between the two populations, showing a more extensive and severe involvement of the left colon in children but the distal ileum in adults. KEY POINTS : • MRI is useful for assessing Crohn's disease in adult and paediatric patients. • Adult and paediatric patients show different intestinal involvement on MRI. • The distal ileum is maximally involved in adults vs. the left colon in children. • The causes of the severe left colonic disease in children are unknown. • The extensive colonic involvement in children has clinical-diagnostic implications.

10 Article Correlation between faecal calprotectin and magnetic resonance imaging (MRI) in the evaluation of inflammatory pattern in Crohn's disease. 2010

Zippi, M / Al Ansari, N / Siliquini, F / Severi, C / Kagarmanova, A / Maffia, C / Parlanti, S / Garbarino, V / Maccioni, F. ·Department of Clinical Sciences, Gastroenterology Unit, University La Sapienza, Rome, Italy. ·Clin Ter · Pubmed #20499020.

ABSTRACT: BACKGROUND: Calprotectin, a major cytosolic protein of neutrophils, is increased in inflammatory bowel disease (IBD) and may be considered a suitable marker of intestinal inflammation. Abdominal MRI is becoming more frequently used for the evaluation of IBD patients. Aim of this study was to investigate the role of MRI in IBD for the assessment of disease activity in comparison with faecal calprotectin levels. PATIENTS AND METHODS: Twenty-four consecutive hospitalized pts (12 F, 12 M, median age: 56; range: 22-77) with a proven diagnosis of CD were studied. At the time of the MRI examination, pts provided a single stool sample for calprotectin measurement. Calprotectin was measured by ELISA (Calprest(R)). Pathological values were considered more than 50 microg/g. All pts underwent MRI, performed at 1.5 T, with HASTE T2w with and without fat-saturation, FLASH T1w fat-saturated sequences pre and post iv injection of 0.1 ml/kg of Gadolinium. Presence, degree and length of wall inflammation were evaluated. The MRI degree of wall inflammation was graded with a 0-3 scoring system (0=absent 1=light 2=moderate 3=severe) by considering findings observed on T1 post Gd and T2 fat-suppressed images, as well as the degree of wall thickness. The length of extension was considered as less than 15 cm, between 15 cm and 30 cm, or more than 30 cm. Spearman's correlation coefficient was used to evaluated differences in calprotectin levels among the groups obtained by MRI findings. RESULTS: Grade 0 MRI was found in 1 pt with a faecal calprotectin measurement of 206.25 microg/g; Grade 1 MRI was found in 4 pts with a median faecal calprotectin of 100 microg/g (5-325); Grade 2 MRI was found in 10 pts with a median faecal calprotectin of 243.75 microg/g (7.5-606.25); Grade 3 MRI was found in 9 pts with a median faecal calprotectin of 1012.5 microg/g (30-1268.8). A trend of positive correlation was therefore found between MRI scores of activity and calprotectin levels (p less than 0.0001) and between MRI scores of thickening of intestinal involvement and calprotectin levels (p = 0.005). No apparent correlation was observed between faecal calprotectin concentration and length. CONCLUSIONS: Data presenting show that faecal calprotectin levels well correlate with the degree of mucosal inflammation are in agreement with previous studies. Considering the correlation obtained between calprotectin level and MRI findings, we believe that MRI is helpful in assessing and monitoring the degree of disease in Crohn's disease.