Adult celiac disease: what is the role of MRI?
OBJECTIVE
To evaluate the ability of MRI to identify intra- and extraintestinal findings of celiac disease in an adult population.


METHODS
Forty-one subjects (18 men and 23 women; mean age = 41.3 years; 31 with biopsy-proven celiac disease, and 10 healthy volunteers) underwent MRI of the small bowel. MR studies were performed on a 1.5-T magnet using T2-weighted half-Fourier single-shot turbo spin-echo (HASTE) and true fast imaging in steady-state precession (True-FISP) sequences. The MR features and sensitivity, and the specificity and accuracy of some of these features are described.


RESULTS
In the 31 celiac patients, MRI showed bowel dilatation in 61.3% (N = 19), increased number of ileal folds in 48.4% (N = 15), reversed fold pattern abnormality in 38.7% (N = 12), increased wall thickness in 16.1% (N = 5), duodenal stenosis in 6.5% (N = 2), intussusception in 12.9% (N = 4), mesenteric lymphadenopathy in 41.9% (N = 13), mesenteric vascular changes in 22.6% (N = 7), ascites in 6.5% (N = 2), and no abnormalities in 12.9% (N = 4). The volunteers had unremarkable exams. The overall specificity and accuracy were 100%, and sensitivity was 79% and 75% for increased number of ileal folders and reversed fold pattern abnormality, respectively.


CONCLUSIONS
MRI is able to demonstrate intra- and extraintestinal features that may lead to the diagnosis of celiac disease in adults.
Tomei
Ernesto
E
Department of Radiological Sciences, University of Rome "La Sapienza," Rome, Italy.
Semelka
Richard C
RC
Braga
Larissa
L
Laghi
Andrea
A
Paolantonio
Pasquale
P
Marini
Mario
M
Passariello
Roberto
R
Di Tola
Marco
M
Sabbatella
Luigi
L
Picarelli
Antonio
A
D000328:Adult; D002446:Celiac Disease / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity