Sensitivity and Specificity of Magnetic Resonance Enterography in the Clinical Management of Fistulizing Crohnʼs Disease

Papadia, Cinzia; Maffei, Erica; Río, Paolo Del; Taylor, Stuart A.; Caini, Saverio; Montana, Chiara; Coruzzi, Alessandro; Franzè, A.; Cademartiri, Filippo; Forbes, Alastair

doi:10.1097/mib.0b013e31828f19a5

Cited by 7 publications

(7 citation statements)

References 38 publications

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“…Nevertheless, a meta-analysis by Qiu et al showed that CT imaging may be better at detecting fistulas and stenosis. However, the results were not statistically significant, and the sensitivities and specificities were comparable to more recently published studies [ 43 , 44 ]. No differences were noted in detecting abscesses.…”

Section: Discussionsupporting

confidence: 86%

Magnetic Resonance Imaging of the Small Bowel in Crohn’s Disease: A Systematic Review and Meta-Analysis

Ahmed

Rodrigues

Nguyen

2016

Canadian Journal of Gastroenterology and Hepatology

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Introduction. Crohn's disease is most commonly found in the terminal ileum and colonic region. Magnetic resonance has become a useful modality for assessing small bowel activity. In this study, we performed a systematic review and meta-analysis on the use of MR in detecting small bowel activity as well as extramural complications in Crohn's patients. Methods. Two independent reviewers sorted through articles until October 2, 2014. We included both studies providing raw data for pooling and studies without raw data. Sensitivity, specificity, likelihood ratios, and 95% confidence intervals were calculated for each study. Results. There were 27 included studies, of which 19 were included in the pooled analysis. Pooled analysis of the 19 studies (1020 patients) with raw data revealed a sensitivity of 0.88 (95% CI 0.86 to 0.91) and specificity was 0.88 (95% CI 0.84 to 0.91). In regard to detecting stenosis, pooled sensitivity was 0.65 (95% CI 0.53 to 0.76) and specificity was 0.93 (95% CI 0.89 to 0.96). Conclusion. MR imaging provides a reliable alternative in detecting small bowel activity in patients with Crohn's disease. Its advantages include high diagnostic accuracy and no radiation exposure while its disadvantages include high cost and limited availability.

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Section: Discussionsupporting

confidence: 86%

Magnetic Resonance Imaging of the Small Bowel in Crohn’s Disease: A Systematic Review and Meta-Analysis

Ahmed

Rodrigues

Nguyen

2016

Canadian Journal of Gastroenterology and Hepatology

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“…According to the research on FC identification of IBD and IBS, the best cut-off value of FC concentration after ROC curve analysis is set to 8 -150 mg/kg, the sensitivity is about 83% -100%, and the specificity is about 51% -100% [12]. The experimental results of this study are similar to those studies.…”

Section: Comparison Of the Positive Rates Of Feia And Elisasupporting

confidence: 64%

A New Immunofluorescence Assay for Fecal Calprotectin Distinguishes Inflammatory Bowel Disease from Functional Bowel Disease

Xu¹,

Rao²,

Liu³

et al. 2018

OJGas

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Aims: To investigate the diagnostic value of fecal calprotectin (FC) determined by a new immunofluorescence assay-fluorescence enzyme immunoassay (FEIA) in patient with inflammatory bowel disease (IBD) or functional bowel disease, compared with the typical ELISA kit. Methods: FC was determined simultaneously by FEIA and an ELISA kit in 26 patients with functional bowel disease and 77 patients with IBD. We compared the difference of FC levels between patients with IBD and patients with functional bowel disease. Receiver operating characteristics curve (ROC) was constructed to obtain the optimal cutoff value of FC for distinguishing IBD from functional bowel disease and the corresponding sensitivity and specificity. Results: The median FC levels of patients with IBD in clinical active stage or clinical remission stage was significantly higher than that of patients with functional bowel disease. The median FC levels of patients with IBD in clinical active stage, IBD in clinical remission stage and functional bowel disease were as follow: 699.91 (346.14 ~ 1647.54) μg/g; 407.36 (121.81 ~ 878.48) μg/g; 39.04 (12.09 ~ 81.04) μg/g when FC was measured by FEIA. The median FC levels were 716.99 (240.42 ~ 1232.53) μg/g; 338.46 (53.08 ~ 692.82) μg/g; 41.44 (11.77 ~ 73.19) μg/g among such above three groups of patients respectively, when FC was measured by ELISA kit. The diagnostic value of IBD with FC determined by FEIA (optimal cutoff = 131.79 μg/g) and ELISA kit (optimal cutoff = 121.85 μg/g) presented an area under the curve of 0.881 and 0.873, respectively. Conclusions: FC determined by FEIA was an accurate surrogate marker to distinguish IBD from functional bowel disease.

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“…The literature search revealed 2501 abstracts related to MRI use in CD. Of these, 244 were retrieved and 62 studies were deemed appropriate for inclusion (Figure ).…”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: magnetic resonance enterography signs for the detection of inflammation and intestinal damage in Crohn's disease

Church

Turner

Feldman

et al. 2014

Aliment Pharmacol Ther

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Summary Background In the treatment of Crohn's disease (CD), mucosal healing has become a major goal, with the hope of avoiding intestinal damage from chronic inflammation. Magnetic resonance enterography (MRE) has emerged as a non‐invasive means of monitoring inflammation and damage. Aims As part of the development of MRE‐based multi‐item measures of inflammation and damage for paediatric studies, we carried out a systematic review and meta‐analysis to identify MRE variables used to describe these two distinct concepts. Methods 2501 studies of MRI and CD were identified. Studies written in any language reporting individual MRE signs for patients diagnosed with CD were included. Two‐hundred‐and‐forty‐four studies were fully reviewed and 62 were included (inflammation, n = 51; damage, n = 24). Sensitivity, specificity and associated confidence intervals were calculated, and hierarchical summary ROC curves were constructed for each MRE sign. Results A total of 22 MRE signs were used to reflect inflammation, and 9 to reflect damage. Diagnostic accuracy of MRE signs of inflammation and damage was heterogeneous; however, wall enhancement, mucosal lesions and wall T2 hyperintensity were the most consistently useful for inflammation (most sensitivities >80% and specificities >90%), and detection of abscess and fistula were most consistently useful for damage (most sensitivities >90%, specificities >95%). Conclusions Identifying the best MRE variables to reflect inflammation and damage will maximise the utility of this rapidly emerging technique and is the first stage of constructing MRE‐based indices for evaluating inflammation and intestinal damage.

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Sensitivity and Specificity of Magnetic Resonance Enterography in the Clinical Management of Fistulizing Crohnʼs Disease

Cited by 7 publications

References 38 publications

Magnetic Resonance Imaging of the Small Bowel in Crohn’s Disease: A Systematic Review and Meta-Analysis

Magnetic Resonance Imaging of the Small Bowel in Crohn’s Disease: A Systematic Review and Meta-Analysis

A New Immunofluorescence Assay for Fecal Calprotectin Distinguishes Inflammatory Bowel Disease from Functional Bowel Disease

Systematic review with meta‐analysis: magnetic resonance enterography signs for the detection of inflammation and intestinal damage in Crohn's disease

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