Magnetic resonance enterocolonography is useful for simultaneous evaluation of small and large intestinal lesions in Crohnʼs disease

Hyun, Sea Bong; Kitazume, Yoshio; Nagahori, Masakazu; Toriihara, Akira; Fujii, Toshimitsu; Tsuchiya, Kiichiro; Suzuki, Shinji; Okada, Eriko; Araki, Akihiro; Naganuma, Makoto; Watanabe, Mamoru

doi:10.1002/ibd.21510

Cited by 43 publications

(24 citation statements)

References 38 publications

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“…We did not include other indices in our analysis because of their inherent limitations such those derived based on expert opinion [15,16], or those derived using fecal calprotectin as reference standard [17] which has the caveat of a low sensitivity for detecting small bowel inflammation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of three magnetic resonance enterography indices for grading activity in Crohn’s disease

et al. 2016

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Background Magnetic resonance enterography (MRE) is an accurate examination for assessing activity in Crohn's disease (CD). Various MRE indices have been developed for that purpose, but have not been directly compared. The aim of the study was to compare the diagnostic accuracy of three MRE indices for detecting and grading disease activity in CD, using endoscopy as gold standard. Methods MRE and ileocolonoscopies performed within 1 month in 43 patients with CD were analyzed. The magnetic resonance index of activity (MaRIA), Clermont, and London indices for each colonic segment and the terminal ileum were calculated. Simplified endoscopy score for CD (SES-CD) was considered the gold standard. Results Two hundred and twenty-four intestinal segments were included in the analysis. According to the established cut-off points for detecting active disease using MaRIA, Clermont, and London indices, the sensitivity of each index was 0.88, 0.89, and 0.71, and the specificity was 0.97, 0.78, and 0.99, respectively. The sensitivity for detecting ulcerations was 0.90 and 0.83 for the MaRIA and Clermont indices, respectively, with a specificity of 0.91 and 0.89. The AUROC curve for the MaRIA, Clermont, and London indices for detecting active disease was 0.92, 0.84, and 0.85, and for detecting ulcerations was 0.90 for the MaRIA, and 0.86 for Clermont index. Conclusions The three MRE-based indices evaluated in the current study have high diagnostic accuracy for assessment of disease activity. The MaRIA index has the best operational characteristics for detecting not only disease activity but also for grading severity, which supports its use in clinical studies and clinical practice.

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Section: Discussionmentioning

confidence: 99%

Comparison of three magnetic resonance enterography indices for grading activity in Crohn’s disease

et al. 2016

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“…MRE is very precise in determining the presence of inflammatory activity (sensitivity 88-98%, specificity 78-100%) (5,11). In addition, MRE allows the level of CD severity to be determined, demonstrating a good correlation with endoscopic findings, especially when the intestinal lumen has been sufficiently distended (12,13). Recently, a radiological index of disease activity, the Magnetic Resonance Index of Activity (MRIA), has been described based on the quantitative changes observed on MRE.…”

Section: Discussionmentioning

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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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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“…MR enterocolonography (MREC) was developed in order to evaluate simultaneously both small and large bowel lesions [37]. Magnesium citrate is taken on the day before the procedure, and 1,000 ml of PEG is taken orally 60 min before MR scanning on the procedure day without nasojejunal intubation or rectal preparation (fig.…”

Section: Mr Enterocolonographymentioning

confidence: 99%

Advancing Magnetic Resonance Imaging in Crohn's Disease

Fujii¹,

Kitazume

Saito³

et al. 2014

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Crohn's disease (CD) is a lifelong chronic inflammatory bowel disease associated with diarrhea, abdominal pain, bloody stool and often perianal fistulae. Inflammation in CD involves the entire gastrointestinal tract, especially including the small and large bowels, causing irreversible bowel damage. Frequent imaging examinations are necessary to monitor disease activity and to evaluate response to therapeutic interventions, and, furthermore, to predict recurrence in order to provide appropriate treatment. The suitable imaging modality should be reproducible, well tolerated, safe and free of ionizing radiation. In recent years, imaging used in CD has dramatically changed. Cross-sectional imaging techniques such as computed tomography and magnetic resonance imaging (MRI) are used to investigate not only extraluminal abnormalities, but also intraluminal changes. Recently, new techniques such as MR enteroclysis, enterography, colonography and enterocolonography have been developed. These recent advances enable the use of MRI to assess bowel disorders with high sensitivity, specificity and accuracy. MRI can evaluate simultaneously the bowel surface, bowel wall, abdominal abscesses and perianal lesions, such as perianal fistulae and perianal abscesses, without the problem of overlapping bowel loops. Therefore, MRI has the potential for evaluation of the overall disease activity of CD without radiation exposure. We believe that MRI is a suitable first choice imaging modality in the assessment of CD.

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Magnetic resonance enterocolonography is useful for simultaneous evaluation of small and large intestinal lesions in Crohnʼs disease

Cited by 43 publications

References 38 publications

Comparison of three magnetic resonance enterography indices for grading activity in Crohn’s disease

Comparison of three magnetic resonance enterography indices for grading activity in Crohn’s disease

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

Advancing Magnetic Resonance Imaging in Crohn's Disease

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