[Combination of dynamic MR enteroclysis (Sellink) and MR colonography to diagnose Crohn's disease].
OBJECTIVE
To investigate whether a combined examination with MRI enteroclysis and MRI colonography is practicable and would provide additional findings in the regions seen with ileo-colonoscopy in the work-up of patients with Crohn's disease.


METHODS
Twenty-five consecutive patients with Crohn's disease (CD) (age range 19 to 42 years, mean age 29.2 years, gender ratio male:female 8:17) were retrospectively studied. All patients underwent conventional ileo-colonoscopy as a standard of reference followed by a combined examination of MRI enteroclysis and MRI colonography at 1.5T within 15 days. Two blinded radiologists evaluated the MRI examinations and compared them with the colonoscopic results.


RESULTS
The MRI examination detected 31 inflamed bowel segments in 25 patients. In comparison to colonoscopy, 5 additional, endoscopically inaccessible lesions were found by MRI and only 2 lesions were missed by MRI. Compared to colonoscopy, MRI found 7 of 10 fistulas detected by colonoscopy, and 3 otherwise indiscernible abscesses. The detection of inflamed bowel segments by means of MRI (endoscopy) revealed a sensitivity of 88.8 % (100 %), specificity of 80 % (100 %) and an overall accuracy of 96 % (100 %).


CONCLUSIONS
This study provides strong evidence that the combination of MRI enteroclysis and MRI colonography is practicable and supplies additional results regarding the regions which are not seen with ileo-colonoscopy in the work-up of patients with Crohn's disease.
Röttgen
R
R
Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin. r.roettgen@t-online.de
Herzog
H
H
Lopez-Hänninen
E
E
Cho
C H
CH
Felix
R
R
Schröder
R J
RJ
D000328:Adult; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
D003287:Contrast Media