title: Prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis: interobserver agreement and sensitivity by means of "sign-by-sign" correlation.
abstract: Our objective was a prospective comparison of MR enteroclysis (MRE) with multidetector spiral-CT enteroclysis (MSCTE). Fifty patients with various suspected small bowel diseases were investigated by MSCTE and MRE. The MSCTE was performed using slices of 2.5 mm, immediately followed by MRE, obtaining T1- and T2-weighted sequences, including gadolinium-enhanced acquisition with fat saturation. Three radiologists independently evaluated MSCTE and MRE searching for 12 pathological signs. Interobserver agreement was calculated. Sensitivities and specificities resulted from comparison with pathological results ( n=29) and patient's clinical evolution ( n=21). Most pathological signs, such as bowel wall thickening (BWT), bowel wall enhancement (BWE) and lymphadenopathy (ADP), showed better interobserver agreement on MSCTE than on MRE (BWT: 0.65 vs 0.48; BWE: 0.51 vs 0.37; ADP: 0.52 vs 0.15). Sensitivity of MSCTE was higher than that of MRE in detecting BWT (88.9 vs 60%), BWE (78.6 vs 55.5%) and ADP (63.8 vs 14.3%). Wilcoxon signed-rank test revealed significantly better sensitivity of MSCTE than that of MRE for each observer ( p=0.028, p=0.046, p=0.028, respectively). Taking the given study design into account, MSCTE provides better sensitivity in detecting lesions of the small bowel than MRE, with higher interobserver agreement.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital CHUV, 1011 Lausanne, Switzerland. sabine.schmidt@chuv.hospvd.ch
authors.forename: Sabine
authors.initials: S
authors.lastname: Schmidt
authors.forename: Domenico
authors.initials: D
authors.lastname: Lepori
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Meuwly
authors.forename: Bertrand
authors.initials: B
authors.lastname: Duvoisin
authors.forename: Reto
authors.initials: R
authors.lastname: Meuli
authors.forename: Pierre
authors.initials: P
authors.lastname: Michetti
authors.forename: Christian
authors.initials: C
authors.lastname: Felley
authors.forename: Pierre
authors.initials: P
authors.lastname: Schnyder
authors.forename: Guy
authors.initials: G
authors.lastname: van Melle
authors.forename: Alban
authors.initials: A
authors.lastname: Denys
mesh_terms: D016477:Artifacts; D003287:Contrast Media; D004733:Enema; D005260:Female; D019786:Gadolinium DTPA; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis; D007275:Injections, Intravenous; D007410:Intestinal Diseases / Q000175:diagnosis*; D007421:Intestine, Small; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008747:Methylcellulose; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D008747:Methylcellulose; D019786:Gadolinium DTPA