Ultrasound and magnetic resonance imaging assessmentof active bowel segments in Crohn's disease.
OBJECTIVE
Determining bowel disease activity in Crohn's patients can be difficult on clinical and laboratory assessment. Endoscopy is invasive and barium studies use ionising radiation. The aim of this study was to compare ultrasound and magnetic resonance imaging (MRI) in detecting Crohn's disease activity in the small or large bowel.


METHODS
Thirty patients, previously diagnosed with Crohn's disease, had bowel ultrasound and MR imaging, and were deemed active or inactive on each test. The 'gold standard' was based on clinical assessment and one or more of the following: endoscopy, barium studies or surgery.


RESULTS
For determining Crohn's disease activity, the sensitivities and specificities of bowel ultrasound and MRI were 87 percent and 100 percent, and 87 percent and 71 percent, respectively. Significant parameters that defined disease activity were bowel wall thickening on ultrasound and MRI, and contrast enhancement of the bowel wall and mesenteric vascularity/stranding on MRI.


CONCLUSIONS
Ultrasound and MRI were both sensitive for determining Crohn's disease activity in the bowel, but MRI with gadolinium enhancement was less specific.
Miao
Y M
YM
Department of Gastroenterology, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
Koh
D-M
DM
Amin
Z
Z
Healy
J C
JC
Chinn
R J S
RJ
Zeegen
R
R
Westaby
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography