Diagnostic accuracies of MR enterography and CT enterography in symptomatic Crohn's disease

Michael Dam Jensen, Jens Kjeldsen, Søren Rafael Rafaelsen, Torben Nathan

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Abstract Objective. In patients, with symptomatic Crohn's disease (CD), valid information about the presence or absence of small bowel disease activity and stenosis is clinically important. Such information supports decisions about medical or surgical therapy and can be obtained with MR enterography (MRE) or CT enterography (CTE). Materials and methods. A total of 50 patients with symptomatic pre-existing CD and a demand for small bowel imaging to support changes in treatment strategy were included in this prospective and blinded study. MRE and CTE were performed on the same day in alternating order and subsequently compared with the gold standard: pre-defined lesions at ileoscopy (n = 30) or surgery with (n = 12) or without (n = 3) intra-operative enteroscopy. Results. A total of 35 patients had active small bowel CD (jejunum 0, ileum 1, (neo)-terminal ileum 34) and 20 had small bowel stenosis. The sensitivity and specificity of MRE for detection of small bowel CD was 74% and 80% compared to 83% and 70% with CTE (p ≥ 0.5). MRE and CTE detected small bowel stenosis with 55% and 70% sensitivities, respectively (p = 0.3) and 92% specificities. Conclusions. MRE and CTE have comparable diagnostic accuracies for detection of small bowel CD and stenosis. In symptomatic patients with CD and high disease prevalence, positive predictive values are favorable but negative predictive values are low. Consequently, MRE and CTE can be relied upon, if a positive result is obtained whereas a negative enterography should be interpreted with caution.
Original languageEnglish
JournalScandinavian Journal of Gastroenterology
Volume46
Issue number12
Pages (from-to)1449-1457
Number of pages9
ISSN0036-5521
DOIs
Publication statusPublished - 2011

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Crohn Disease
Pathologic Constriction
Ileum
Preexisting Condition Coverage
Jejunum
Prospective Studies

Cite this

@article{0ffc6700ae3a44e1b2f97324ef4f35f9,
title = "Diagnostic accuracies of MR enterography and CT enterography in symptomatic Crohn's disease",
abstract = "Abstract Objective. In patients, with symptomatic Crohn's disease (CD), valid information about the presence or absence of small bowel disease activity and stenosis is clinically important. Such information supports decisions about medical or surgical therapy and can be obtained with MR enterography (MRE) or CT enterography (CTE). Materials and methods. A total of 50 patients with symptomatic pre-existing CD and a demand for small bowel imaging to support changes in treatment strategy were included in this prospective and blinded study. MRE and CTE were performed on the same day in alternating order and subsequently compared with the gold standard: pre-defined lesions at ileoscopy (n = 30) or surgery with (n = 12) or without (n = 3) intra-operative enteroscopy. Results. A total of 35 patients had active small bowel CD (jejunum 0, ileum 1, (neo)-terminal ileum 34) and 20 had small bowel stenosis. The sensitivity and specificity of MRE for detection of small bowel CD was 74{\%} and 80{\%} compared to 83{\%} and 70{\%} with CTE (p ≥ 0.5). MRE and CTE detected small bowel stenosis with 55{\%} and 70{\%} sensitivities, respectively (p = 0.3) and 92{\%} specificities. Conclusions. MRE and CTE have comparable diagnostic accuracies for detection of small bowel CD and stenosis. In symptomatic patients with CD and high disease prevalence, positive predictive values are favorable but negative predictive values are low. Consequently, MRE and CTE can be relied upon, if a positive result is obtained whereas a negative enterography should be interpreted with caution.",
author = "Jensen, {Michael Dam} and Jens Kjeldsen and Rafaelsen, {S{\o}ren Rafael} and Torben Nathan",
year = "2011",
doi = "10.3109/00365521.2011.613947",
language = "English",
volume = "46",
pages = "1449--1457",
journal = "Scandinavian Journal of Gastroenterology",
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}

Diagnostic accuracies of MR enterography and CT enterography in symptomatic Crohn's disease. / Jensen, Michael Dam; Kjeldsen, Jens; Rafaelsen, Søren Rafael; Nathan, Torben.

In: Scandinavian Journal of Gastroenterology, Vol. 46, No. 12, 2011, p. 1449-1457.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Diagnostic accuracies of MR enterography and CT enterography in symptomatic Crohn's disease

AU - Jensen, Michael Dam

AU - Kjeldsen, Jens

AU - Rafaelsen, Søren Rafael

AU - Nathan, Torben

PY - 2011

Y1 - 2011

N2 - Abstract Objective. In patients, with symptomatic Crohn's disease (CD), valid information about the presence or absence of small bowel disease activity and stenosis is clinically important. Such information supports decisions about medical or surgical therapy and can be obtained with MR enterography (MRE) or CT enterography (CTE). Materials and methods. A total of 50 patients with symptomatic pre-existing CD and a demand for small bowel imaging to support changes in treatment strategy were included in this prospective and blinded study. MRE and CTE were performed on the same day in alternating order and subsequently compared with the gold standard: pre-defined lesions at ileoscopy (n = 30) or surgery with (n = 12) or without (n = 3) intra-operative enteroscopy. Results. A total of 35 patients had active small bowel CD (jejunum 0, ileum 1, (neo)-terminal ileum 34) and 20 had small bowel stenosis. The sensitivity and specificity of MRE for detection of small bowel CD was 74% and 80% compared to 83% and 70% with CTE (p ≥ 0.5). MRE and CTE detected small bowel stenosis with 55% and 70% sensitivities, respectively (p = 0.3) and 92% specificities. Conclusions. MRE and CTE have comparable diagnostic accuracies for detection of small bowel CD and stenosis. In symptomatic patients with CD and high disease prevalence, positive predictive values are favorable but negative predictive values are low. Consequently, MRE and CTE can be relied upon, if a positive result is obtained whereas a negative enterography should be interpreted with caution.

AB - Abstract Objective. In patients, with symptomatic Crohn's disease (CD), valid information about the presence or absence of small bowel disease activity and stenosis is clinically important. Such information supports decisions about medical or surgical therapy and can be obtained with MR enterography (MRE) or CT enterography (CTE). Materials and methods. A total of 50 patients with symptomatic pre-existing CD and a demand for small bowel imaging to support changes in treatment strategy were included in this prospective and blinded study. MRE and CTE were performed on the same day in alternating order and subsequently compared with the gold standard: pre-defined lesions at ileoscopy (n = 30) or surgery with (n = 12) or without (n = 3) intra-operative enteroscopy. Results. A total of 35 patients had active small bowel CD (jejunum 0, ileum 1, (neo)-terminal ileum 34) and 20 had small bowel stenosis. The sensitivity and specificity of MRE for detection of small bowel CD was 74% and 80% compared to 83% and 70% with CTE (p ≥ 0.5). MRE and CTE detected small bowel stenosis with 55% and 70% sensitivities, respectively (p = 0.3) and 92% specificities. Conclusions. MRE and CTE have comparable diagnostic accuracies for detection of small bowel CD and stenosis. In symptomatic patients with CD and high disease prevalence, positive predictive values are favorable but negative predictive values are low. Consequently, MRE and CTE can be relied upon, if a positive result is obtained whereas a negative enterography should be interpreted with caution.

U2 - 10.3109/00365521.2011.613947

DO - 10.3109/00365521.2011.613947

M3 - Journal article

C2 - 21905974

VL - 46

SP - 1449

EP - 1457

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

IS - 12

ER -