Magnetic Resonance Enterography and Capsule Endoscopy in Patients Undergoing Patency Capsule for the Evaluation of Small Bowel Crohn's Disease: A Korean Clinical Experience

Hyun Seok Lee; Yun Jeong Lim; Jin-Hee Jung; Ji Hyung Nam; Junseok Park; Sun Hyung Kang; Ki Bae Kim; Hoon Jai Chun

doi:10.1155/2020/8129525

Magnetic Resonance Enterography and Capsule Endoscopy in Patients Undergoing Patency Capsule for the Evaluation of Small Bowel Crohn's Disease: A Korean Clinical Experience

Gastroenterol Res Pract. 2020 Apr 4:2020:8129525. doi: 10.1155/2020/8129525. eCollection 2020.

Authors

Hyun Seok Lee¹, Yun Jeong Lim², Jin-Hee Jung³, Ji Hyung Nam², Junseok Park⁴, Sun Hyung Kang⁵, Ki Bae Kim⁶, Hoon Jai Chun⁷

Affiliations

¹ Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
² Department of Internal Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
³ Department of Radiology, Dongguk University College of Medicine, Goyang, Republic of Korea.
⁴ Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
⁵ Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
⁶ Department of Internal Medicine, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.
⁷ Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.

Abstract

Objective: Studies comparing magnetic resonance enterography (MRE) and capsule endoscopy (CE) for the assessment of small bowel (SB) Crohn's disease (CD) are scarce in Korea. In addition, there is no Korean experience of patency capsule (PC) examination prior to CE. The primary aim of this study was to compare diagnostic yields of MRE and CE for the assessment of SB CD. Secondary objectives were to compare the detection rate of proximal SB lesions by each modality in the Montreal classification and evaluate the safety and feasibility of PC in Korean CD patients.

Methods: MRE was performed as the first examination to assess SB CD. PC examination and CE were then performed. Diagnostic yields of active SB disease by MRE and CE were then analyzed.

Results: Disintegration of the patency capsule was shown in 5 patients out of 26 patients, who did not undergo CE. These 5 patients were accounted as negative CE findings. Overall, MRE and CE detected 80.8% and 65.4% of active SB lesions of CD in 26 patients, respectively (P = 0.212). MRE and CE detected 0% (0/26) and 19.2% (5/26) (P = 0.051) of jejunal lesions, 30.8% (8/26) and 42.3% (11/26) (P = 0.388) of proximal ileal lesions, and 80.8% (21/26) and 53.8% (14/26) (P = 0.039) of terminal ileal lesions, respectively. According to the Montreal classification, MRE and CE independently detected proximal disease (L4) in 30.8% (8/26) and 53.8% (14/26) (P = 0.092), respectively.

Conclusions: The diagnostic yields of MRE and CE for the assessment of SB CD including proximal SB lesions were similar. MRE is a more objective tool for detecting clinically relevant stricture than PC although PC examination could be performed safely before CE to prove the patency of SB. This trial is registered with KCT0004305.