title: Magnetic resonance enterography for Crohn's disease: what the surgeon can take home.
abstract: BACKGROUND
  Crohn's disease (CD) is a life-long, chronic, relapsing condition requiring often morphological assessment. MR enterography (MRE) offers advantages of not using ionizing radiation and yielding intraluminal and intra-abdominal informations. The aim of our study was to identify how MRE can be useful in planning surgical procedures.
  
  
  METHODS
  In this retrospective study, 35 patients who underwent MRE and then surgery for CD were enrolled from 2006 to 2010. MRE findings were compared to intraoperative findings. Histology of operative specimens, systemic inflammatory parameters, and fecal lactoferrin were also evaluated. Cohen's κ agreement test, sensitivity and sensibility, uni-/multivariate logistic regression, and non-parametric statistics were performed.
  
  
  RESULTS
  MRE identified bowel stenosis with a sensitivity of 0.95 (95% CI 0.76-0.99) and a specificity of 0.72 (95% CI 0.39-0.92). The concordance of MRE findings with intraoperative findings was high [Cohen's κ = 0.72 (0.16)]. Abscesses were detected at MRE with a sensitivity of 0.92 (95% CI 0.62-0.99) and a specificity of 0.90 (95% CI 0.69-0.98) with a Cohen's κ = 0.82 (0.16). The grade of proximal bowel dilatation resulted to be a significant predictor of the possibility of using strictureplasty instead of/associated to bowel resection either at univariate or at multivariate analysis.
  
  
  CONCLUSIONS
  Our study confirmed that MRE findings correlate significantly with disease activity. Detailed information about abscess could suggest percutaneous drainage that could ease the following surgery or avoid emergency laparotomy. Proximal bowel dilatation can suggest the possibility to perform bowel sparing surgery such as strictureplasty.
authors.affiliation: Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Pozza
authors.forename: Marco
authors.initials: M
authors.lastname: Scarpa
authors.forename: Carmelo
authors.initials: C
authors.lastname: Lacognata
authors.forename: Francesco
authors.initials: F
authors.lastname: Corbetti
authors.forename: Claudia
authors.initials: C
authors.lastname: Mescoli
authors.forename: Cesare
authors.initials: C
authors.lastname: Ruffolo
authors.forename: Mauro
authors.initials: M
authors.lastname: Frego
authors.forename: Renata
authors.initials: R
authors.lastname: D'Incà
authors.forename: Romeo
authors.initials: R
authors.lastname: Bardini
authors.forename: Massimo
authors.initials: M
authors.lastname: Rugge
authors.forename: Giacomo Carlo
authors.initials: GC
authors.lastname: Sturniolo
authors.forename: Imerio
authors.initials: I
authors.lastname: Angriman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult