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Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn's disease.
AJR Am J Roentgenol. 2009 Jul; 193(1):113-21.AA

Abstract

OBJECTIVE

The objective of our study was to prospectively obtain pilot data on the accuracy of MR enterography for detecting small-bowel Crohn's disease compared with CT enterography and with a clinical reference standard based on imaging, clinical information, and ileocolonoscopy.

SUBJECTS AND METHODS

The study group for this blinded prospective study was composed of 33 patients with suspected active Crohn's ileal inflammation who were scheduled for clinical CT enterography and ileocolonoscopy and had consented to also undergo MR enterography. The MR enterography and CT enterography examinations were each interpreted by two radiologists with disagreements resolved by consensus. The reports from ileocolonoscopy with or without mucosal biopsy were interpreted by a gastroenterologist. The reference standard for the presence of small-bowel Crohn's disease was based on the final clinical diagnosis by the referring gastroenterologist after reviewing all of the available information.

RESULTS

All 33 patients underwent CT enterography and ileocolonoscopy, 30 of whom also underwent MR enterography. The sensitivities of MR enterography and CT enterography for detecting active small-bowel Crohn's disease were similar (90.5% vs 95.2%, respectively; p = 0.32). The image quality scores for MR enterography examinations were significantly lower than those for CT enterography (p = 0.005). MR enterography and CT enterography identified eight cases (24%) with a final diagnosis of active small-bowel inflammation in which the ileal mucosa appeared normal at ileocolonoscopy. Furthermore, enterography provided the only available imaging in three additional patients who did not have ileal intubation.

CONCLUSION

MR enterography and CT enterography have similar sensitivities for detecting active small-bowel inflammation, but image quality across the study cohort was better with CT. Cross-sectional enterography provides complementary information to ileocolonoscopy.

Authors+Show Affiliations

Department of Radiology, Mayo Clinic, 200 First St., SW, Rochester, MN 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19542402

Citation

Siddiki, Hassan A., et al. "Prospective Comparison of State-of-the-art MR Enterography and CT Enterography in Small-bowel Crohn's Disease." AJR. American Journal of Roentgenology, vol. 193, no. 1, 2009, pp. 113-21.
Siddiki HA, Fidler JL, Fletcher JG, et al. Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn's disease. AJR Am J Roentgenol. 2009;193(1):113-21.
Siddiki, H. A., Fidler, J. L., Fletcher, J. G., Burton, S. S., Huprich, J. E., Hough, D. M., Johnson, C. D., Bruining, D. H., Loftus, E. V., Sandborn, W. J., Pardi, D. S., & Mandrekar, J. N. (2009). Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn's disease. AJR. American Journal of Roentgenology, 193(1), 113-21. https://doi.org/10.2214/AJR.08.2027
Siddiki HA, et al. Prospective Comparison of State-of-the-art MR Enterography and CT Enterography in Small-bowel Crohn's Disease. AJR Am J Roentgenol. 2009;193(1):113-21. PubMed PMID: 19542402.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn's disease. AU - Siddiki,Hassan A, AU - Fidler,Jeff L, AU - Fletcher,Joel G, AU - Burton,Sharon S, AU - Huprich,James E, AU - Hough,David M, AU - Johnson,C Daniel, AU - Bruining,David H, AU - Loftus,Edward V,Jr AU - Sandborn,William J, AU - Pardi,Darrell S, AU - Mandrekar,Jayawant N, PY - 2009/6/23/entrez PY - 2009/6/23/pubmed PY - 2009/7/16/medline SP - 113 EP - 21 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 193 IS - 1 N2 - OBJECTIVE: The objective of our study was to prospectively obtain pilot data on the accuracy of MR enterography for detecting small-bowel Crohn's disease compared with CT enterography and with a clinical reference standard based on imaging, clinical information, and ileocolonoscopy. SUBJECTS AND METHODS: The study group for this blinded prospective study was composed of 33 patients with suspected active Crohn's ileal inflammation who were scheduled for clinical CT enterography and ileocolonoscopy and had consented to also undergo MR enterography. The MR enterography and CT enterography examinations were each interpreted by two radiologists with disagreements resolved by consensus. The reports from ileocolonoscopy with or without mucosal biopsy were interpreted by a gastroenterologist. The reference standard for the presence of small-bowel Crohn's disease was based on the final clinical diagnosis by the referring gastroenterologist after reviewing all of the available information. RESULTS: All 33 patients underwent CT enterography and ileocolonoscopy, 30 of whom also underwent MR enterography. The sensitivities of MR enterography and CT enterography for detecting active small-bowel Crohn's disease were similar (90.5% vs 95.2%, respectively; p = 0.32). The image quality scores for MR enterography examinations were significantly lower than those for CT enterography (p = 0.005). MR enterography and CT enterography identified eight cases (24%) with a final diagnosis of active small-bowel inflammation in which the ileal mucosa appeared normal at ileocolonoscopy. Furthermore, enterography provided the only available imaging in three additional patients who did not have ileal intubation. CONCLUSION: MR enterography and CT enterography have similar sensitivities for detecting active small-bowel inflammation, but image quality across the study cohort was better with CT. Cross-sectional enterography provides complementary information to ileocolonoscopy. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/19542402/full_citation L2 - https://www.ajronline.org/doi/10.2214/AJR.08.2027 DB - PRIME DP - Unbound Medicine ER -