title: Assessment of Crohn's disease in the small bowel: Prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis.
abstract: Our objective was to assess the diagnostic value of magnetic resonance enteroclysis (MRE) compared with conventional enteroclysis (CE) in patients with Crohn's disease. A secondary objective was to evaluate the diagnostic accuracy of each different MR sequence. Sixty-six consecutive patients with known Crohn's disease underwent MRE and CE. Fast imaging employing steady-state acquisition (FIESTA), single-shot fast spin-echo (ssFSE), and contrast-enhanced T1-weighted sequences were assessed by two radiologists who reached a consensus about the following findings: visualization of wall ulcers, pseudopolyps, fistulae, mural stenosis, and mesenteric abnormalities. Standard descriptive statistics and the McNemar test were used. The sensitivity, specificity and accuracy of MRE were 90-87% and 83% for the depiction of parietal ulcers, 84%-88% and 86% for pseudopolyps, 100-94% and 96% for mural stenosis, 93-100% and 94% for fistulae. The number of detected extraluminal findings was significantly higher with MRE (P < 0.01). The accuracy of FIESTA sequence was statistically higher in the depiction of wall ulcers and fistulae than that of three-dimensional fast spoiled gradient echo (3D-FSPGR) (P < 0.01) and ssFSE (P < 0.05) sequences. Contrast-enhanced 3D-FSPGR was superior for mural stenosis visualization compared to ssFSE (P < 0.05) and FIESTA (P < 0.05). MRE correlates accurately with CE in the detection of superficial and transmural abnormalities and has the advantage of assessing the mesenteric manifestations.
authors.affiliation: Radiology DEA Department, Umberto I Academic Hospital, University La Sapienza, Viale del Policlinico, 155-00161 Rome, Italy. gabrielemasselli@libero.it
authors.forename: Gabriele
authors.initials: G
authors.lastname: Masselli
authors.forename: Emanuele
authors.initials: E
authors.lastname: Casciani
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Polettini
authors.forename: Silvia
authors.initials: S
authors.lastname: Lanciotti
authors.forename: Luca
authors.initials: L
authors.lastname: Bertini
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Gualdi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003287:Contrast Media; D003424:Crohn Disease / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007421:Intestine, Small / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media