A prospective randomized comparison between two MRI studies of the small bowel in Crohn's disease, the oral contrast method and MR enteroclysis.
The aim was to compare bowel distension and diagnostic properties of magnetic resonance imaging of the small bowel with oral contrast (MRI per OS) with magnetic resonance enteroclysis (MRE). Forty patients with suspected Crohn's disease (CD) were examined with both MRI methods. MRI per OS was performed with a 6% mannitol solution and MRE with nasojejunal intubation and a polyethylenglycol solution. MRI protocol consisted of balanced fast field echo (B-FFE), T2 and T1 sequences with and without gadolinium. Two experienced radiologists individually evaluated bowel distension and pathological findings including wall thickness (BWT), contrast enhancement (BWE), ulcer (BWU), stenosis (BWS) and edema (EDM). The diameter of the small bowel was smaller with MRI per OS than with MRE (difference jejunum: 0.55 cm, p < 0.001; ileum: 0.35 cm, p < 0.001, terminal ileum: 0.09 cm, p = 0.08). However, CD was diagnosed with high diagnostic accuracy (sensitivity, specificity, positive and negative predictive values: MRI per OS 88%, 89%, 89%, 89%; MRE 88%, 84%, 82%, 89%) and inter-observer agreement (MRI per OS k = 0.95; MRE k = 1). In conclusion, bowel distension was inferior in MRI per OS compared to MRE. However, both methods diagnosed CD with a high diagnostic accuracy and reproducibility.
Negaard
Anne
A
Department of Radiology, Ullevål University Hospital and Faculty of Medicine, University of Oslo, Kirkeveien 166, 0407 Oslo, Norway. anne.negard@medisin.uio.no
Paulsen
Vemund
V
Sandvik
Leiv
L
Berstad
Audun Elnaes
AE
Borthne
Arne
A
Try
Kirsti
K
Lygren
Idar
I
Storaas
Tryggve
T
Klow
Nils-Einar
NE
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage; D003424:Crohn Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007421:Intestine, Small; D007441:Intubation, Gastrointestinal; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media