title: Comparison of MR enteroclysis with MR enterography and conventional enteroclysis in patients with Crohn's disease.
abstract: To prospectively compare the diagnostic accuracy of MR enteroclysis with duodenal intubation with MRI after drinking oral contrast agent only (MR enterography) with conventional enteroclysis (conv-E) as reference standard in patients with Crohn's disease. Forty consecutive patients (22 males and 18 females; mean age 36; range 16-74 years) with proven Crohn's disease underwent conv-E and MR imaging. Twenty-two patients underwent MR enteroclysis with intubation (MRE) and 18 underwent MR-enterography (MR per OS). Two radiologists reached a consensus about the following imaging findings: luminal distension and visualization of superficial mucosal, mural and mesenteric abnormalities. Standard descriptive statistics and a Wilcoxon rank sum test were used. Statistical significance was inferred at P < 0.05. There was no significant difference in the adequacy of luminal distention between the MRE and conv-E (P = 0.08), and both were statistically superior in comparison to MR per OS in the distension of the jejunum (P < 0.01) and less significant at the ileum and terminal ileum levels (P < 0.05). MRE and conv-E were comparable for the accuracy of superficial mucosal abnormalities; meanwhile conv-E compared with MR per OS was statistically superior (P < 0.01). MRE compared with MR per OS was statistically better when visualizing superficial abnormalities (P < 0.01). No statistically significant differences were found in assessing the diagnostic efficacy between MR examinations for the depiction of mural stenosis (P = 0.105) and fistulae (P = 0.67). The number of detected mesenteric findings was significantly higher with both MRE and MR per OS compared to conv-E (P < 0.01). MRE can serve as the diagnostic procedure for initially evaluating patients suspected of having Crohn's disease. MR per OS may have a role in patients that refuse or have failed intubation and also for follow-up.
authors: Radiology DEA Department, Academic Hospital Umberto I. La Sapienza University Rome, Viale del Policlinico 155, 00161 Rome, Italy. gabrielemasselli@libero.it
authors: Gabriele
authors: G
authors: Masselli
authors: Emanuele
authors: E
authors: Casciani
authors: Elisabetta
authors: E
authors: Polettini
authors: Gianfranco
authors: G
authors: Gualdi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001466:Barium Sulfate / Q000008:administration & dosage*; D003287:Contrast Media / Q000008:administration & dosage*; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D004386:Duodenum; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology; D007413:Intestinal Mucosa / Q000473:pathology; D007441:Intubation, Gastrointestinal; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate