Comparison of magnetic resonance and balloon enteroscopic examination of the small intestine in patients with crohn's disease

Kento Takenaka, Kazuo Ohtsuka, Yoshio Kitazume, Masakazu Nagahori, Toshimitsu Fujii, Eiko Saito, Makoto Naganuma, Akihiro Araki, Mamoru Watanabe

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Background & Aims Magnetic resonance (MR) enterography is a recommended imaging technique for detecting intestinal involvement in Crohn's disease (CD). However, the diagnostic accuracy of MR enterography has not been compared directly what that of enteroscopy of the jejunum and proximal ileum. We evaluated the usefulness of MR enterocolonography (MREC) by comparing its findings with those from balloon-assisted enteroscopy. Methods In a prospective study, MREC and enteroscopy were performed within 3 days of each other on 100 patients. Ulcerative lesions and all mucosal lesions were evaluated. Physicians and radiologists were blinded to results from other studies. Findings from MREC were compared directly with those from enteroscopy; the sensitivity and specificity with which MREC detected CD lesions were assessed. Results MREC detected ulcerative lesions and all mucosal lesions in the small intestine with 82.4% sensitivity (95% confidence interval [CI], 75.4%-87.7%) and 67.5% sensitivity (95% CI, 63.1%-70.0%); specificity values were 87.6% (95% CI, 83.7%-90.6%) and 94.8% (95% CI, 90.1%-97.5%). MREC detected major stenosis with 58.8% sensitivity (95% CI, 37.6%-77.2%) and 90.0% specificity (95% CI, 88.4%-91.5%) and all stenoses with 40.8% sensitivity (95% CI, 30.8%-49.4%) and 93.7% specificity (95% CI, 91.1%-95.9%). Conclusions MREC is useful for detecting active lesions in the small intestine. However, MR imaging is less sensitive for detecting intestinal damage, such as stenoses. Enteroscopy is preferred for identifying intestinal damage. Suitable imaging approaches should be selected to assess CD lesions in deep small intestine.

Original languageEnglish
JournalGastroenterology
Volume147
Issue number2
DOIs
Publication statusPublished - 2014
Externally publishedYes

Fingerprint

Crohn Disease
Small Intestine
Magnetic Resonance Spectroscopy
Confidence Intervals
Pathologic Constriction
Jejunum
Ileum
Magnetic Resonance Imaging
Prospective Studies
Physicians
Sensitivity and Specificity

Keywords

  • Diagnosis
  • IBD
  • Intestinal Damage
  • Ulcer

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Comparison of magnetic resonance and balloon enteroscopic examination of the small intestine in patients with crohn's disease. / Takenaka, Kento; Ohtsuka, Kazuo; Kitazume, Yoshio; Nagahori, Masakazu; Fujii, Toshimitsu; Saito, Eiko; Naganuma, Makoto; Araki, Akihiro; Watanabe, Mamoru.

In: Gastroenterology, Vol. 147, No. 2, 2014.

Research output: Contribution to journalArticle

Takenaka, Kento ; Ohtsuka, Kazuo ; Kitazume, Yoshio ; Nagahori, Masakazu ; Fujii, Toshimitsu ; Saito, Eiko ; Naganuma, Makoto ; Araki, Akihiro ; Watanabe, Mamoru. / Comparison of magnetic resonance and balloon enteroscopic examination of the small intestine in patients with crohn's disease. In: Gastroenterology. 2014 ; Vol. 147, No. 2.
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abstract = "Background & Aims Magnetic resonance (MR) enterography is a recommended imaging technique for detecting intestinal involvement in Crohn's disease (CD). However, the diagnostic accuracy of MR enterography has not been compared directly what that of enteroscopy of the jejunum and proximal ileum. We evaluated the usefulness of MR enterocolonography (MREC) by comparing its findings with those from balloon-assisted enteroscopy. Methods In a prospective study, MREC and enteroscopy were performed within 3 days of each other on 100 patients. Ulcerative lesions and all mucosal lesions were evaluated. Physicians and radiologists were blinded to results from other studies. Findings from MREC were compared directly with those from enteroscopy; the sensitivity and specificity with which MREC detected CD lesions were assessed. Results MREC detected ulcerative lesions and all mucosal lesions in the small intestine with 82.4{\%} sensitivity (95{\%} confidence interval [CI], 75.4{\%}-87.7{\%}) and 67.5{\%} sensitivity (95{\%} CI, 63.1{\%}-70.0{\%}); specificity values were 87.6{\%} (95{\%} CI, 83.7{\%}-90.6{\%}) and 94.8{\%} (95{\%} CI, 90.1{\%}-97.5{\%}). MREC detected major stenosis with 58.8{\%} sensitivity (95{\%} CI, 37.6{\%}-77.2{\%}) and 90.0{\%} specificity (95{\%} CI, 88.4{\%}-91.5{\%}) and all stenoses with 40.8{\%} sensitivity (95{\%} CI, 30.8{\%}-49.4{\%}) and 93.7{\%} specificity (95{\%} CI, 91.1{\%}-95.9{\%}). Conclusions MREC is useful for detecting active lesions in the small intestine. However, MR imaging is less sensitive for detecting intestinal damage, such as stenoses. Enteroscopy is preferred for identifying intestinal damage. Suitable imaging approaches should be selected to assess CD lesions in deep small intestine.",
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T1 - Comparison of magnetic resonance and balloon enteroscopic examination of the small intestine in patients with crohn's disease

AU - Takenaka, Kento

AU - Ohtsuka, Kazuo

AU - Kitazume, Yoshio

AU - Nagahori, Masakazu

AU - Fujii, Toshimitsu

AU - Saito, Eiko

AU - Naganuma, Makoto

AU - Araki, Akihiro

AU - Watanabe, Mamoru

PY - 2014

Y1 - 2014

N2 - Background & Aims Magnetic resonance (MR) enterography is a recommended imaging technique for detecting intestinal involvement in Crohn's disease (CD). However, the diagnostic accuracy of MR enterography has not been compared directly what that of enteroscopy of the jejunum and proximal ileum. We evaluated the usefulness of MR enterocolonography (MREC) by comparing its findings with those from balloon-assisted enteroscopy. Methods In a prospective study, MREC and enteroscopy were performed within 3 days of each other on 100 patients. Ulcerative lesions and all mucosal lesions were evaluated. Physicians and radiologists were blinded to results from other studies. Findings from MREC were compared directly with those from enteroscopy; the sensitivity and specificity with which MREC detected CD lesions were assessed. Results MREC detected ulcerative lesions and all mucosal lesions in the small intestine with 82.4% sensitivity (95% confidence interval [CI], 75.4%-87.7%) and 67.5% sensitivity (95% CI, 63.1%-70.0%); specificity values were 87.6% (95% CI, 83.7%-90.6%) and 94.8% (95% CI, 90.1%-97.5%). MREC detected major stenosis with 58.8% sensitivity (95% CI, 37.6%-77.2%) and 90.0% specificity (95% CI, 88.4%-91.5%) and all stenoses with 40.8% sensitivity (95% CI, 30.8%-49.4%) and 93.7% specificity (95% CI, 91.1%-95.9%). Conclusions MREC is useful for detecting active lesions in the small intestine. However, MR imaging is less sensitive for detecting intestinal damage, such as stenoses. Enteroscopy is preferred for identifying intestinal damage. Suitable imaging approaches should be selected to assess CD lesions in deep small intestine.

AB - Background & Aims Magnetic resonance (MR) enterography is a recommended imaging technique for detecting intestinal involvement in Crohn's disease (CD). However, the diagnostic accuracy of MR enterography has not been compared directly what that of enteroscopy of the jejunum and proximal ileum. We evaluated the usefulness of MR enterocolonography (MREC) by comparing its findings with those from balloon-assisted enteroscopy. Methods In a prospective study, MREC and enteroscopy were performed within 3 days of each other on 100 patients. Ulcerative lesions and all mucosal lesions were evaluated. Physicians and radiologists were blinded to results from other studies. Findings from MREC were compared directly with those from enteroscopy; the sensitivity and specificity with which MREC detected CD lesions were assessed. Results MREC detected ulcerative lesions and all mucosal lesions in the small intestine with 82.4% sensitivity (95% confidence interval [CI], 75.4%-87.7%) and 67.5% sensitivity (95% CI, 63.1%-70.0%); specificity values were 87.6% (95% CI, 83.7%-90.6%) and 94.8% (95% CI, 90.1%-97.5%). MREC detected major stenosis with 58.8% sensitivity (95% CI, 37.6%-77.2%) and 90.0% specificity (95% CI, 88.4%-91.5%) and all stenoses with 40.8% sensitivity (95% CI, 30.8%-49.4%) and 93.7% specificity (95% CI, 91.1%-95.9%). Conclusions MREC is useful for detecting active lesions in the small intestine. However, MR imaging is less sensitive for detecting intestinal damage, such as stenoses. Enteroscopy is preferred for identifying intestinal damage. Suitable imaging approaches should be selected to assess CD lesions in deep small intestine.

KW - Diagnosis

KW - IBD

KW - Intestinal Damage

KW - Ulcer

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