Clermont score calculator of ileocolonic Crohn’s disease activity (MRI)

Notes

The Clermont score

• The score is calculated using the following formula:
  • 1.646 × bowel thickness(mm) − 1.321 × ADC + 5.613 × edema + 8.306 × ulceration + 5.039
• The ADC value should be measured for each segment in the area of highest DWI signal intensity in the bowel wall.
• Bowel wall hyperintensity is defined as hyperintensity compared to the psoas muscle on T2-weighted images, similarly to the MaRIA score.
• Cut-off values of the Clermont score are:
  • active disease >8.4
  • severe disease >12.5
• The original publication (open access):
  • ^{Buisson A, Joubert A, Montoriol PF, Da Ines D, Hordonneau C, Pereira B, Garcier JM, Bommelaer G, Petitcolin V. Diffusion-weighted magnetic resonance imaging for detecting and assessing ileal inflammation in Crohn’s disease. Aliment Pharmacol Ther. 2013 Mar;37(5):537-45. doi: 10.1111/apt.12201. Epub 2013 Jan 7. Erratum in: Aliment Pharmacol Ther. 2013 May;37(10):1031. Ines, D D [corrected to Da Ines, D]. PMID: 23289713.}

Clermont score and the MaRIA index

• The Clermont score is derived from the MaRIA scoring system, however it does not require the use of intravenous gadolinium, which has become important in the recent years due to concerns about the long-term effects of repeated contrast-enhanced MRI exams.
• It has been shown that the Clermont and MaRIA scores are comparable in evaluating mucosal inflammation.
  • ^{Buisson A, Pereira B, Goutte M, Reymond M, Allimant C, Obritin-Guilhen H, Bommelaer G, Hordonneau C. Magnetic resonance index of activity (MaRIA) and Clermont score are highly and equally effective MRI indices in detecting mucosal healing in Crohn’s disease. Dig Liver Dis. 2017 Nov;49(11):1211-1217. doi: 10.1016/j.dld.2017.08.033. Epub 2017 Aug 31. PMID: 28919192.}
  • ^{Puylaert CAJ, Nolthenius CJT, Tielbeek JAW, Makanyanga JC, Rodriguez-Justo M, Brosens LAA, Nio CY, Pendsé DA, Ponsioen CY, Vos FM, Taylor SA, Stoker J. Comparison of MRI Activity Scoring Systems and Features for the Terminal Ileum in Patients With Crohn Disease. AJR Am J Roentgenol. 2019 Feb;212(2):W25-W31. doi: 10.2214/AJR.18.19876. Epub 2018 Dec 12. PMID: 30540212.}

Last updated: 2021-10-25