In this study, researchers from London, England, assessed fistula track healing after infliximab treatment, using magnetic resonance imaging.
They performed both magnetic resonance imaging and clinical evaluation, before and after a course of 3 infliximab infusions.
The research team then evaluated the magnetic resonance images for abscesses and fistula tracks.
The team used the images taken before and after treatment to evaluate patients as "better", "unchanged" or "worse".
Furthermore, the team compared magnetic resonance imaging and clinical outcomes.
|Clinical outcome and magnetic resonance imaging correlated in 7 out of 10 patients.|
|Alimentary Pharmacology and Therapeutics|
The research team found that out of 12 patients, pre-treatment magnetic resonance imaging detected abscesses in 3 - 2 of these patients were not treated.
Of the remaining10 patients, 7 had peri-anal fistulas (2 also had recto-vaginal fistulas), and 3 had abdominal wall entero-cutaneous fistulas.
Following the infliximab treatment, 4 patients were found to be in remission, 1 had a response and 5 were non-responders. In addition, 1 patient developed a peri-anal abscess.
The researchers found that magnetic resonance imaging improved in 6 patients, was unchanged in 2, and was worse in 2.
In 4 of the 6 patients who showed improvement in magnetic resonance imaging, the fistula track resolved, however 2 of these had clinically persistent entero-cutaneous fistulas.
The team found that the clinical outcome and magnetic resonance imaging correlated in 7 of the 10 patients. However, in 3 (2 entero-cutaneous and 1 peri-anal), there was discordance.
Dr Bell's team concluded, "Magnetic resonance imaging identifies clinically silent sepsis".
"Fistulas may persist despite clinical remission."
"Clinical response to infliximab and clinical correlation with magnetic resonance imaging were poor in patients with abdominal entero-cutaneous fistulas."