Assessment of Crohn's disease in the small bowel: Prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis

Eur Radiol. 2006 Dec;16(12):2817-27. doi: 10.1007/s00330-006-0338-7. Epub 2006 Jun 24.

Abstract

Our objective was to assess the diagnostic value of magnetic resonance enteroclysis (MRE) compared with conventional enteroclysis (CE) in patients with Crohn's disease. A secondary objective was to evaluate the diagnostic accuracy of each different MR sequence. Sixty-six consecutive patients with known Crohn's disease underwent MRE and CE. Fast imaging employing steady-state acquisition (FIESTA), single-shot fast spin-echo (ssFSE), and contrast-enhanced T1-weighted sequences were assessed by two radiologists who reached a consensus about the following findings: visualization of wall ulcers, pseudopolyps, fistulae, mural stenosis, and mesenteric abnormalities. Standard descriptive statistics and the McNemar test were used. The sensitivity, specificity and accuracy of MRE were 90-87% and 83% for the depiction of parietal ulcers, 84%-88% and 86% for pseudopolyps, 100-94% and 96% for mural stenosis, 93-100% and 94% for fistulae. The number of detected extraluminal findings was significantly higher with MRE (P < 0.01). The accuracy of FIESTA sequence was statistically higher in the depiction of wall ulcers and fistulae than that of three-dimensional fast spoiled gradient echo (3D-FSPGR) (P < 0.01) and ssFSE (P < 0.05) sequences. Contrast-enhanced 3D-FSPGR was superior for mural stenosis visualization compared to ssFSE (P < 0.05) and FIESTA (P < 0.05). MRE correlates accurately with CE in the detection of superficial and transmural abnormalities and has the advantage of assessing the mesenteric manifestations.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Contrast Media
  • Crohn Disease / pathology*
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Intestine, Small / pathology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity

Substances

  • Contrast Media