Document Detail

Endoscopy and MR enteroclysis: equivalent tools in predicting clinical recurrence in patients with Crohn's disease after ileocolic resection.
MedLine Citation:
PMID:  19504611     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Ileocolonoscopy poses the gold standard in the evaluation of postoperative recurrence of Crohn's disease (CD) at the site of ileocolonic anastomosis. Magnetic resonance enteroclysis (MRE) on the other hand is a promising technique for small bowel imaging. The aim was to compare MRE and ileocolonoscopy for predicting clinical recurrence in CD patients who have undergone ileocolonic resection. METHODS: We included 29 patients in the study. The median time since index operation was 35 months and between ileocolonoscopy and MRE was 3 days. Patients were followed up for a maximum of 2 years unless clinical recurrence occurred earlier. Endoscopic findings were evaluated on a 5-grade scale (i0-i4), whereas MRE findings on the neoterminal ileum and anastomosis were assessed according to a previously validated 4-grade scale MR score (MR0-MR3). RESULTS: By classifying patients into subgroups of endoscopic severity of postoperative recurrence using as a threshold an endoscopic score of i3, we found that 10% of patients in the i0 to i2 group had a clinical recurrence during the 2-year follow-up period as compared to 52.6% of subjects with i3 to i4 (P = 0.043). The corresponding clinical exacerbation rates in the subgroups based on MRE severity assessment were 12.5% for MR0 to MR1 and 50% for MR2 to MR3 (P = 0.09). CONCLUSIONS: Our data suggest that colonoscopy and MR enteroclysis are of similar value to predict the risk of clinical recurrence in postoperative patients with Crohn's disease.
Stavroula Koilakou; Johannes Sailer; Philipp Peloschek; Arnulf Ferlitsch; Harald Vogelsang; Wolfgang Miehsler; Joel Fletcher; Karl Turetschek; Wolfgang Schima; Walter Reinisch
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Inflammatory bowel diseases     Volume:  16     ISSN:  1536-4844     ISO Abbreviation:  Inflamm. Bowel Dis.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-18     Completed Date:  2010-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508162     Medline TA:  Inflamm Bowel Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  198-203     Citation Subset:  IM    
Department of Internal Medicine III, Division of Gastroenterology, Medical University of Vienna, Austria.
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MeSH Terms
Colon / pathology,  surgery
Crohn Disease / diagnosis*,  pathology,  surgery
Kaplan-Meiers Estimate
Magnetic Resonance Imaging / methods*
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Severity of Illness Index
Time Factors
Young Adult

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