Document Detail


Feasibility of Using MR Enterography (MRE) for the Assessment of Terminal Ileitis and Inflammatory Activity in Children with Crohn's Disease (CD).
MedLine Citation:
PMID:  22241511     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Radiation exposure increases cancer risk in children with Crohn's Disease (CD). MR Enterography (MRE) can image the gastrointestinal (GI) tract without exposure to radiation. OBJECTIVES:: To determine if our MRE protocol can diagnose terminal ileitis and degree of inflammatory activity in children with CD. METHODS:: Retrospective review of patients 18 years of age or less who underwent MRE for known or suspected CD from June 15, 2007 to April 1, 2010. MRE was performed with Volumen (EZ-EM Inc, New York, USA) and water as oral contrast and gadolinium-based IV contrast. No antiperistaltic agent was used. Each MRE was compared with ileal biopsies obtained within 90 days. Severity of inflammation on MRE was scored and compared with the Pediatric Crohn's Disease Activity Index (PCDAI). RESULTS:: 72 patients underwent 80 MRE's during the study period. 42 of the 72 patients (58.3%) underwent colonoscopy within 90 days of MRE, and the terminal ileum was intubated in 33. Compared with histology, MRE had a sensitivity of 71.4% and a specificity of 100% for terminal ileitis. The positive and negative predictive values were 100% and 70% respectively. PCDAI was calculated in 39 of the 72 patients (54.2%) and had a statistically significant positive correlation with MRE score of 0.37 (p = 0.020426). CONCLUSIONS:: In children with known or suspected CD, our MRE protocol has a high specificity and positive predictive value for terminal ileitis. Severity of inflammation on MRE had a statistically significant positive correlation with PCDAI.
Authors:
Jared Silverstein; David Grand; David Kawatu; Samir A Shah; Jill Steinkeler; Neal Leleiko
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-10
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Warren Alpert Medical School of Brown University, Division of Pediatric Gastroenterology, Nutrition, and Liver Disease, Hasbro Children's Hospital / Rhode Island Hospital, Providence, RI, USA. †Warren Alpert Medical School of Brown University, Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA. ‡Warren Alpert Medical School of Brown University, Division of Gastroenterology, Providence, RI, USA.
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