Magnetic resonance imaging of the effects of infliximab on perianal fistulizing XXXX .

@entity1 @entity32 @entity82 @entity292 @entity30
OBJECTIVES: Although the clinical efficacy of infliximab as measured by closure of @entity292 in @entity30 has been demonstrated, its influence on the inflammatory changes in the @entity292 tracks is less clear. The aim of the present study was to assess the behavior of perianal @entity292 before and after infliximab treatment. METHODS: Magnetic resonance imaging (MRI) and clinical evaluation were performed in a total of 18 @entity1 before and after treatment with infliximab. An MRI-based score of perianal @entity30 severity was developed using both criteria of local extension of @entity292 (complexity, supralavetoric extension, relation to the sphincters and of active @entity32 (T2 hyperintensity, presence of cavities/abscesses, and rectal wall involvement). RESULTS: The MRI score was reliable in assessing the @entity292 tracks, with a good interobserver concordance (p < 0.001). Fistula tracks with signs of active @entity32 were found in all 18 @entity1 at baseline and collections in seven. After short-term infliximab treatment, active tracks persisted in eight of 11 @entity1 who had clinically responded to infliximab. After long-term (46 wk) infliximab therapy, MRI signs of @entity32 had resolved in three of six @entity1 . CONCLUSIONS: We have developed an MRI-based score of perianal @entity30 severity to assess the anatomical evolution of @entity30 . Our study demonstrates that despite closure of draining external orifices after infliximab therapy, @entity292 tracks persist with varying degrees of @entity32 , which may cause recurrent @entity292 and pelvic abscesses. Whether @entity82 occurs over time with repeated infliximab infusions needs further study.
