Magnetic resonance enterography with and without biphasic contrast agent enema compared to conventional ileocolonoscopy in patients with Crohn's disease

Friedrich, Chris and Fajfar, Alenka and Pawlik, Michael and Hoffstetter, Patrick and Rennert, Janine and Agha, Ayman and Jung, Ernst M. and Ott, Claudia and Stroszczynski, Christian and Schreyer, Andreas G. (2012) Magnetic resonance enterography with and without biphasic contrast agent enema compared to conventional ileocolonoscopy in patients with Crohn's disease. INFLAMMATORY BOWEL DISEASES, 18 (10). pp. 1842-1848. ISSN 1078-0998,

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Abstract

Background: Magnetic resonance imaging (MRI) of the bowel is a valuable diagnostic tool for assessing disease activity in patients with inflammatory bowel disease (IBD). We compared magnetic resonance enterography (MRE) with and without water enema to conventional ileocolonoscopy to evaluate the advantage of a water enema for MRI diagnostics of Crohn's disease (CD). Methods: We prospectively evaluated 50 patients with known CD. MRE with enema was performed in 23 cases, whereas 27 patients received an MRE without enema. All patients underwent conventional ileocolonoscopy. We assessed the degree of inflammation in both modalities, evaluating up to seven bowel segments in each patient. We compared MRE with and without rectal enema to each other and to conventional ileocolonoscopy. Results: MRE achieved a sensitivity and specificity of 100% and 74%, respectively, for detection of inflammation in the terminal ileum with enema and a sensitivity and specificity of 72% and 87%, respectively, without enema. Considering the colon, MRE with enema had a sensitivity of 79% (specificity 96%), while the examination without enema showed a sensitivity of 38% (specificity 99%). MRE with enema proved statistically superior to MRE without enema in detecting inflammation in the terminal ileum, ascending colon, and rectum (P < 0.05). Conclusions: MRE with enema is a valuable diagnostic tool for assessing inflammation in CD patients. Water enema is well tolerated and significantly improves detection of inflammation in the terminal ileum. Water enema should therefore be included in MRE protocols for CD patients. (Inflamm Bowel Dis 2012)

Item Type: Article
Uncontrolled Keywords: INFLAMMATORY-BOWEL-DISEASE; MR COLONOGRAPHY; FEASIBILITY; DIAGNOSIS; Crohn's disease; magnetic resonance imaging; magnetic resonance enterography
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Chirurgie
Medicine > Lehrstuhl für Innere Medizin I
Medicine > Lehrstuhl für Röntgendiagnostik
Depositing User: Dr. Gernot Deinzer
Date Deposited: 06 May 2020 04:50
Last Modified: 06 May 2020 04:50
URI: https://pred.uni-regensburg.de/id/eprint/18063

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