Crohn Disease of the Small Bowel: Preliminary Comparison among CT Enterography, Capsule Endoscopy, Small-Bowel Follow-through, and Ileoscopy

Hara, Amy K.; Leighton, Jonathan A.; Heigh, Russell I.; Sharma, Virender K.; Silva, Alvin C.; Petris, Giovanni De; Hentz, Joseph G.; Fleischer, David E.

doi:10.1148/radiol.2381050296

Cited by 266 publications

(158 citation statements)

References 18 publications

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“…Classically, the study of the small intestine in CD was performed using SBFT. Different studies have shown the superiority of MRE and CT enterography over SBFT for the study of CD (3,4). The advantages of MRE over CT enterography are the absence of ionising radiation, the ability to perform multiple slices in segments of the intestine which allows low-grade obstructions to be detected and the ability to distinguish between inflammatory activity and fibrosis (8).…”

Section: Discussionmentioning

confidence: 99%

“…Studies (3,4) have shown that SBFT is less accurate than other radiologic techniques to detect the presence of active CD in the small intestine. Technological advances have led to the growing use of contrast ultrasound, computed tomography (CT) and magnetic resonance enterography (MRE) in the study of the CD in the small intestine, to the point that in the last consensus of the European Crohn's and Colitis Organisation (ECCO) (5,6), enterography by MR and CT are the imaging techniques recommended to determine the extent of CD in the small intestine.…”

Section: Introductionmentioning

confidence: 99%

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Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: First year of experience

Mendoza

González-Lama

Taxonera

et al. 2012

Rev. esp. enferm. dig.

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Objective: to describe the experience at two tertiary centres during the first year of use of magnetic resonance enterography (MRE) for the management of Crohn's disease (CD): indications and influence of the technique in clinical decision making.Materials and methods: retrospective descriptive study in which patients who underwent MRE were included consecutively. Epidemiological and clinical data were collected from the patients, as well as the indication for the study and how it influenced clinical decision making in the 10 days following the radiological study.Results: 24 MREs were performed in suspected CD and 126 known CD; partial bowel obstruction in 53 patients (42%), monitoring of medical treatment in 34 (27%), due to incomplete ileocolonoscopy in 16 (13%), extension study of the small intestine in 15 (12%) and suspected complicated CD in 8 patients (6%). The MRE influenced in a change in treatment in 83 (55.3%) patients: 16 (10.7%) started with immunosuppressants, 41 (27.3%) with antiTNFa were started on or switched, 15 (10%) were ordered surgery and in 3 (2%) changed from combined therapy to monotherapy. The MRE had less influence on clinical decision making in the group in which the indication was suspected CD (p < 0.05).Conclusions: the use of MRE helped on decision making in more than half of patients, especially with regards to decisions related to the use of biological therapies and the indication for surgery. MRE was less useful in suspected CD patients

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: First year of experience

Mendoza

González-Lama

Taxonera

et al. 2012

Rev. esp. enferm. dig.

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“…Transabdominal ultrasound or endoscopic ultrasonography, CT, or magnetic resonance imaging (MRI) can delineate and discriminate intra-abdominal masses / abscesses or perianal complications (66) . Recently, CT and MRI enterography have been used and early evaluation suggests e cacy in the evaluation of small bowel pathology in patients with CD (67 -70) .…”

Section: Imaging Studiesmentioning

confidence: 99%

Management of Crohn's Disease in Adults

2009

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Guidelines for clinical practice are intended to suggest preferable approaches to particular medical problems as established by interpretation and collation of scientifi cally valid research, derived from extensive review of published literature. When data that will withstand objective scrutiny are not available, a recommendation may be made based on a consensus of experts. Guidelines are intended to apply to the clinical situation for all physicians without regard to specialty. Guidelines are intended to be fl exible, not necessarily indicating the only acceptable approach, and should be distinguished from standards of care that are infl exible and rarely violated. Given the wide range of choices in any health-care problem, the physician should select the course best suited to the individual patient and the clinical situation presented. These guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee. Expert opinion is solicited from the outset for the document. The quality of evidence upon which a specifi c recommendation is based is as follows: Grade A: Homogeneous evidence from multiple well-designed randomized (therapeutic) or cohort (descriptive) controlled trials, each involving a number of participants to be of suffi cient statistical power. Grade B: Evidence from at least one large well-designed clinical trial with or without randomization, from cohort or case -control analytic studies, or well-designed meta-analysis. Grade C: Evidence based on clinical experience, descriptive studies, or reports of expert committees. The Committee reviews guidelines in depth, with participation from experienced clinicians and others in related fi elds. The fi nal recommendations are based on the data available at the time of the production of the document and may be updated with pertinent scientifi c developments at a later time.

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“…Capsule endoscopy provides meaningful information on the inflammatory burden in the small bowel mucosa, similarly to the role of conventional ileocolonoscopy for the colon and the terminal ileum. Bowel stenosis should be ruled [81] 35 77% 20% 47% < 0.05 Hara et al [82] 17 71% 53% 18% NA Voderholzer et al [83] 41 61% 49% (CT enteroclysis) 12% < 0.04 Solem et al [84] 40 83% 83% 0 NS MRE Albert et al [85] 27 93% 78% 15% NS Crook et al [22] 19 93% 71% 18% NS Jensen et al [20] 93 100% 86% 14% NS Ileocolonoscopy Hara et al [82] 17 71% 65% 6% NS Solem et al [84] 40 83% 74% 9% NS Leighton et al [86] 80 be demonstrated in 73%-93% of the patients within 1 year of ileocolonic resection [29,30] . SB lesions associated with postoperative recurrence are frequently quantified using the Rutgeerts score [29] .…”

Section: Vce In Established CDmentioning

confidence: 99%

Role of capsule endoscopy in inflammatory bowel disease

Leighton

Legnani

Seidman

2007

Inflammatory Bowel Diseases

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Videocapsule endoscopy (VCE) has revolutionized our ability to visualize the small bowel mucosa. This modality is a valuable tool for the diagnosis of obscure small bowel Crohn's disease (CD), and can also be used for monitoring of disease activity in patients with established small-bowel CD, detection of complications such as obscure bleeding and neoplasms, evaluation of response to anti-inflammatory treatment and postoperative recurrence following small bowel resection. VCE could also be an important tool in the management of patients with unclassified inflammatory bowel disease, potentially resulting in reclassification of these patients as having CD. Reports on postoperative monitoring and evaluation of patients with ileal pouch-anal anastomosis who have developed pouchitis have recenty been published. Monitoring of colonic inflammatory activity in patients with ulcerative colitis using the recently developed colonic capsule has also been reported. Capsule endoscopy is associated with an excellent safety profile. Although retention risk is increased in patients with small bowel CD, this risk can be significanty decreased by a routine utilization of a dissolvable patency capsule preceding the ingestion of the diagnostic capsule. This paper contains an overview of the current and future WJG 20 th Anniversary Special Issues (3): Inflammatory bowel disease TOPIC HIGHLIGHTclinical applications of capsule endoscopy in inflammatory bowel disease.

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Crohn Disease of the Small Bowel: Preliminary Comparison among CT Enterography, Capsule Endoscopy, Small-Bowel Follow-through, and Ileoscopy

Abstract: This preliminary study demonstrates capsule endoscopy and CT enterography may depict nonobstructive Crohn disease when techniques such as ileoscopy and SBFT have negative or inconclusive findings.

Cited by 266 publications

References 18 publications

Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: First year of experience

Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: First year of experience

Management of Crohn's Disease in Adults

Role of capsule endoscopy in inflammatory bowel disease

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