Abstract Background Crohn’s disease (CD) is a chronic inflammatory condition of the gastrointestinal tract, characterized by a relapsing and remitting course. It is a progressive disorder that leads to cumulative bowel damage and long-term disability. Magnetic resonance enterography (MRE) is an important tool for diagnosis and management of patients with CD. Several radiological scoring systems are used to assess CD on MRE, primarily to quantify inflammation, guide treatment and monitor disease. Magnetic Resonance Index of Activity (MaRIA) and its simplified form sMaRIA being the most widely used and validated systems. Methods We retrospectively evaluated 121 patients with a confirmed diagnosis of CD who underwent both MRE and endoscopy at our institution less than six months apart. Patients were selected from our institutional UR-CARE registry database based on the availability of complete clinical, endoscopic, and radiologic records. MREs were independently scored by an abdominal radiologist and a radiology resident using the sMaRIA score for each intestinal segment, while endoscopic findings were reviewed and evaluated using the SES-CD. Study objectives: to show the degree of correlation between disease activity and disease severity assessed by sMaRIA criteria and SES-CD and to assess the reliability of the sMaRIA criteria by comparing MRE assessments performed independently by an experienced abdominal radiologist and a radiology resident with limited experience. Results We found Strongest segmental correlations of endoscopic SES-CD score with radiological MRE sMaRIA score in terminal ileum, transverse colon and left/sigmoid colon. Correlation was weak but still significant in the rectal segment and weak but non-significant in ascending colon (table 1). sMaRIA score prediction of the activity/severity of disease based on the global SES-CD score showed substantial discriminative ability to distinguish between active and inactive endoscopic activity, between mild and moderate to severe endoscopic activity, moderate discriminative ability to distinguish between severe and non-severe endoscopic activity (graph 1). Interobserver variability of the sMaRIA revealed consistently strong agreement between the radiology specialist and the resident across all intestinal segments. Conclusion Our study demonstrated moderate to substantial sMARIA ability to accurately predict CD activity using SES-CD as a reference. The interrater reliability between a radiology resident and an expert was excellent, supporting sMARIA as a suitable instrument for clinical practice. References: 1. Roseira J, Ventosa AR, de Sousa HT, et al. The new simplified MARIA score applies beyond clinical trials: A suitable clinical practice tool for Crohn’s disease that parallels a simple endoscopic index and fecal calprotectin. United European Gastroenterol J. 2020;8 (10):1208-16. 2. Lee WE, Weng MT, Wei SC, et al. Comparison of the magnetic resonance scoring systems for Crohn’s disease activity: MaRIA, simplified MaRIA, and Nancy scores. Abdom Radiol (NY). 2023;48(7):2228-36. Conflict of interest: Dr. Ocepek, Andreja: No conflict of interest Tumpej, Tina: No conflict of interest Bombek Rudolf, Saša: No conflict of interest Putniković, Dunja: No conflict of interest Nikolic, Sara: No conflict of interest
Ocepek et al. (2026) studied this question.