Mean length and severity of ileal inflammation within this group were 10 cm and 1.6, respectively.

Within this group of 59, 68% had subsequent surgical resection with active inflammatory CD in the pathological specimen, 70% had radiographic worsening of disease and 61% had ulcers observed at subsequent ileoscopy. 67% (59/88) of patients with negative ileoscopy and ileal biopsy results had evidence of confirmed progression.Within this group of 44, 45% had proximal small bowel inflammation, 32% had stricture and 11% had fistulas. 50% (44/88) of patients with negative ileoscopy and ileal biopsy results had moderate or severe inflammation on enterography.Within this group of 88 patients, researchers noted these additional significant findings:

And 6% (88/1,471) had imaging findings of inflammation on CTE/ MRE, but results of both ileoscopy and ileal biopsy were negative. Of the 1,471 study participants who underwent enterography and ileoscopy at the time of initial consultation, 8% (112/1,471) had imaging findings of inflammation on CTE/ MRE within the distal 20 cm of the terminal ileum, but negative ileoscopy results (normal appearance of the intubated terminal ileum). Unlikely or unconfirmed inflammation: no evidence of inflammation on subsequent CTE/ MRE, subsequent negative ileocolonoscopy and biopsies, or no subsequent Crohn's-related medical therapy or surgery.Radiologic response: evidence of decreased inflammation after medical therapy (biologic or immunomodulator).Confirmed progression: evidence of subsequent surgery, radiological worsening, new ulcers at ileoscopy or positive histology.With this information, they then placed participants into one of the following categories: They also reviewed the study population's subsequent medical records for evidence of surgery, ulceration at ileoscopy, histological inflammation, or new or worsening ileal inflammation or stricture on enterography. Researchers used enterography results to document the severity and length of inflammation within the distal 20 cm of the terminal ileum for each of the 1,471 individuals. All imaging studies exceeded the minimum technical criteria for these exams as specified by the Society of Abdominal Radiology. In a retrospective review, researchers identified 1,471 individuals diagnosed with CD who underwent ileoscopy and biopsy within 30 days of CT or MRE showing ileal inflammation. When enterography and ileocolonoscopy offer what appears to be conflicting information, how should clinicians interpret these findings and use them to guide management of these patients? Noting the lack of data addressing this question, a team of Mayo Clinic researchers conducted a study published in the Journal of Crohn's and Colitis (JCC) in 2020.

While CTE and MRE provide complementary findings to ileocolonoscopy, small bowel inflammation may exist, even when concurrent endoscopic examination of the terminal ileum is negative (normal appearance). Computerized tomography enterography (CTE) and magnetic resonance enterography (MRE) of the small bowel have become routine and show a high degree of accuracy in evaluating patients with established or suspected CD in the small bowel.

Endo biopsy positive for inflammation