Detecting inflammation in the unprepared pediatric colon — how reliable is magnetic resonance enterography?

Barber, Joy L.; Lozinsky, Adriana Chebar; Kiparissi, F.; Shah, Neil; Watson, Tom

doi:10.1007/s00247-015-3538-y

Cited by 13 publications

(23 citation statements)

References 15 publications

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“…Four MRE scoring systems were reviewed: the Magnetic Resonance Index of Activity (MARIA), the Crohn's Disease Magnetic Resonance Imaging Index (CDMI), the Magnetic Resonance Enterography Global Score (MEGS), and the Visual Analogue Scale (VAS). The MARIA, MEGS, and VAS were evaluated against the SES-CD (Table I) [7][8][9][10][11][12][13][14][15][16].…”

Section: Resultsmentioning

confidence: 99%

“…The study by Barber et al [15] proved that the accuracy in determining the presence of active inflammation on biopsy was comparable for segmental MEGS (specificity 90% (95% CI: 79.5-96.2%) and sensitivity 60% (95% CI: 40.6-77.3%)) and for colonoscopy (specificity 85% (95% CI: 73.4-92.9%) and sensitivity 53.3% (95% CI: 34.3-71.6%)). This study reported that increasing bowel distention did not significantly change the accuracy of detecting active inflammation, although, due to a small number of patients involved, there were large confidence intervals [15]. In another study, Barber et al [16] showed that the reproducibility of MEGS was poor, both at the segment level and the total patient level.…”

Section: Magnetic Resonance Enterography Global Score (Megs)mentioning

confidence: 99%

“…The diagnostic accuracy of MEGS for identifying inflammation in the terminal ileum with endoscopy as the reference standard was high [14]. The study by Barber et al [15] proved that the accuracy in determining the presence of active inflammation on biopsy was comparable for segmental MEGS (specificity 90% (95% CI: 79.5-96.2%) and sensitivity 60% (95% CI: 40.6-77.3%)) and for colonoscopy (specificity 85% (95% CI: 73.4-92.9%) and sensitivity 53.3% (95% CI: 34.3-71.6%)). This study reported that increasing bowel distention did not significantly change the accuracy of detecting active inflammation, although, due to a small number of patients involved, there were large confidence intervals [15].…”

Section: Magnetic Resonance Enterography Global Score (Megs)mentioning

confidence: 99%

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A review of magnetic resonance enterography based Crohn’s disease activity indices in paediatric patients

Herman¹,

Dumnicka²,

Fyderek³

2022

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Magnetic resonance enterography (MRE) is a commonly used method for non-invasive diagnosing and following of inflammatory bowel disease (IBD). Numerous reviews that compare and discuss MRE-based Crohn's disease (CD) activity indices for adults have been published; however, no reviews of this kind have been published for children. Following a PubMed database literature search (January 2008 -November 2021), out of 316 research papers, 10 original papers about MRE-CD activity indices were included in the analysis. Four MRE-based scoring systems were discussed: Magnetic Resonance Index of Activity (MARIA), the Crohn's Disease Magnetic Resonance Imaging Index (CDMI), the Magnetic Resonance Enterography Global Score (MEGS) and the Visual Analogue Scale (VAS). This review revealed that in the last 13 years, studies have proven that MRE-based CD activity indices correspond with endoscopic findings and clinical scores of CD activity.

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Section: Resultsmentioning

confidence: 99%

Section: Magnetic Resonance Enterography Global Score (Megs)mentioning

confidence: 99%

Section: Magnetic Resonance Enterography Global Score (Megs)mentioning

confidence: 99%

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A review of magnetic resonance enterography based Crohn’s disease activity indices in paediatric patients

Herman¹,

Dumnicka²,

Fyderek³

2022

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“…Although in general, paediatric practice follows that of adults [90, 91], there are important exceptions.…”

Section: Discussionmentioning

confidence: 99%

The first joint ESGAR/ ESPR consensus statement on the technical performance of cross-sectional small bowel and colonic imaging

et al. 2016

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ObjectivesTo develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease.MethodsAn expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols.ResultsOne hundred and fifty-seven statements were scored for agreement by the panel of which 129 statements (82 %) achieved immediate consensus with a further 19 (12 %) achieving consensus after appropriate modification. Nine (6 %) statements were rejected as consensus could not be reached.ConclusionsThese expert consensus recommendations can be used to help guide cross-sectional radiological practice for imaging the small bowel and colon.Key points• Cross-sectional imaging is increasingly used to evaluate the bowel • Image quality is paramount to achieving high diagnostic accuracy • Guidelines concerning patient preparation and image acquisition protocols are provided

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“…Magnetic resonance (MR) enterography has rapidly emerged as the diagnostic imaging modality of choice to identify disease involvement and assess disease activity. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Magnetic resonance enterography has the advantage of being noninvasive, lacking ionizing radiation, and demonstrating excellent soft-tissue contrast. Because children are more sensitive to ionizing radiation and they have to undergo multiple imaging studies during their lifetime to monitor disease activity, MR enterography is the best radiologic imaging modality in the field of pediatric IBD.…”

mentioning

confidence: 99%

Diagnostic Performance of Magnetic Resonance Enterography for Detection of Active Inflammation in Children and Adolescents With Inflammatory Bowel Disease

Yoon

Suh²,

Kim

et al. 2017

JAMA Pediatr

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IMPORTANCE Magnetic resonance (MR) enterography has the advantage over other techniques of being noninvasive, lacking ionizing radiation, and demonstrating excellent soft-tissue contrast to evaluate pediatric patients with inflammatory bowel disease (IBD).OBJECTIVE To evaluate the diagnostic performance of MR enterography for detection of active inflammation in children and adolescents with known or suspected IBD.DATA SOURCES A search of MEDLINE and EMBASE up to January 2, 2017, was performed to identify studies. Search terms included child, pediatric, adolescent, Crohn disease, inflammatory bowel disease, and magnetic resonance enterography. The search was limited to English-language publications.STUDY SELECTION Studies evaluating the diagnostic performance of MR enterography for detection of active inflammation in pediatric patients with known or suspected IBD were selected. Two reviewers independently assessed the eligibility of the selected articles. DATA EXTRACTION AND SYNTHESISThe study was performed and reported in accordance with the PRISMA guidelines. Pooled summary estimates of sensitivity and specificity were calculated using hierarchical logistic regression modeling. MAIN OUTCOMES AND MEASURESThe diagnostic performance of MR enterography for detection of active inflammation in pediatric patients with known or suspected IBD was the primary outcome. Subgroup analyses and meta-regression were performed. RESULTSEighteen original articles involving a total of 687 patients were included. The summary sensitivity was 83% (95% CI, 75%-89%), the summary specificity was 93% (95% CI, 90%-95%), and the area under the hierarchical summary receiver operating characteristic curve was 0.95 (95% CI, 0.93-0.97). The Higgins I 2 statistics demonstrated substantial heterogeneity in terms of sensitivity (I 2 = 84.1%) and specificity (I 2 = 68.8%). Based on per-patient analysis, the summary sensitivity was 86% (95% CI, 78%-91%) and specificity was 91% (95% CI, 82%-96%). In meta-regression, among the various potential covariates, scanner manufacturer was associated with study heterogeneity.CONCLUSIONS AND RELEVANCE Magnetic resonance enterography, which is a noninvasive, radiation-free modality, demonstrates high diagnostic performance in the diagnosis of active inflammation in pediatric patients with IBD, especially at the per-patient level.

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Detecting inflammation in the unprepared pediatric colon — how reliable is magnetic resonance enterography?

Cited by 13 publications

References 15 publications

A review of magnetic resonance enterography based Crohn’s disease activity indices in paediatric patients

A review of magnetic resonance enterography based Crohn’s disease activity indices in paediatric patients

The first joint ESGAR/ ESPR consensus statement on the technical performance of cross-sectional small bowel and colonic imaging

Diagnostic Performance of Magnetic Resonance Enterography for Detection of Active Inflammation in Children and Adolescents With Inflammatory Bowel Disease

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