Document Detail

Acute complications of Crohn's disease: comparison of multidetector-row computed tomographic enterography with magnetic resonance enterography.
MedLine Citation:
PMID:  20588038     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare multidetector-row computed tomographic (MDCT) enterography with magnetic resonance (MR) enterography performed upon acute exacerbation of Crohn's disease.
SUBJECTS AND METHODS: Fifty-seven patients (mean age 33.5) with proven Crohn's disease and symptoms suggesting acute exacerbation were prospectively included. After oral administration of 1-2 liters of 5% methylcellulose, MDCT and MR enterography were performed on each patient (mean delay <24 h). Three radiologists blindly and independently evaluated each examination for technical quality and in terms of 8 pathological features of Crohn's disease. Observers' agreement, sensitivity and specificity resulted from comparison with the reference standard [surgery (n = 24), endoscopy (n = 17) and long-term follow-up (n = 16)].
RESULTS: MDCT enterography demonstrated fewer artifacts than MR enterography (p < 0.0001). In 48 MDCT/MR enterography examinations, active disease was demonstrated: abscesses (n = 11), fistulas (n = 13), stenoses (n = 23) and/or intestinal inflammation (n = 38). Observers' agreement (range 0.56-0.87) was not significantly different between MDCT and MR enterography, neither in terms of sensitivity (range 58-95%) nor specificity (range 67-100%) for each of the 8 pathological features.
CONCLUSION: Statistically, MR enterography is of similar diagnostic value as MDCT enterography for acute complications of Crohn's disease. Since the typical Crohn's disease patient is young and will very likely undergo life-long imaging, and given concerns about radiation exposure with MDCT, MR enterography should be the preferred modality.
Sabine Schmidt; Aymeric Guibal; Jean-Yves Meuwly; Pierre Michetti; Christian Felley; Reto Meuli; Pierre Schnyder; Alban Denys
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-25
Journal Detail:
Title:  Digestion     Volume:  82     ISSN:  1421-9867     ISO Abbreviation:  Digestion     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-27     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150472     Medline TA:  Digestion     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  229-38     Citation Subset:  IM    
Department of Radiology, University Hospital, CHUV, Lausanne, Switzerland.
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MeSH Terms
Acute Disease
Crohn Disease / complications*
Image Interpretation, Computer-Assisted
Magnetic Resonance Imaging / methods*
Middle Aged
Prospective Studies
Sensitivity and Specificity
Statistics, Nonparametric
Tomography, X-Ray Computed / methods*

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