Ultra-high-field magnetic resonance enterography in the diagnosis of ileitis (Neo-)terminalis: a prospective study.
OBJECTIVE
Magnetic resonance (MR) enterography provides the advantages of conventional enteroclysis and those of cross-sectional imaging. Adequate luminal distension, combined with ultrafast sequences, results in excellent delineation of mural and extramural manifestations of Crohn's disease. Recent technical advances, including ultra-high-field strength MR with its capability to provide fast multiplanar images with excellent soft tissue contrast, are only rarely included in abdominal studies.


METHODS
One hundred four consecutive patients with a proved or suspected diagnosis of ileitis terminalis were prospectively selected for MR imaging studies and ileocolonoscopy. The final diagnosis was based on histopathological findings or based on a combined endpoint of clinical, laboratory, endoscopic, and imaging findings.


RESULTS
According to the endoscopic examination, stenosis was present in 26 patients (25%) and could be ruled out in 78 patients (75%). Total agreement between MR and endoscopy could be reached in 74 patients (71%). Histology indicated absence of inflammation in 50 patients (48%). MR and endoscopic findings were concordant in 38 patients (76%) and 37 patients (74%), respectively. Corresponding results by ileocolonoscopy were 37 true negative, 29 true positive, 4 false positive, and 12 false negative (sensitivity, 70.7%; specificity, 74%).


CONCLUSIONS
MR enterography with a 3.0-T scanner is a powerful tool in the evaluation of ileal diseases, and has therefore made MR enterography the first-line modality at our institution in patients with suspected inflammatory bowel disease.
2nd Med. Department, Klinikum Leverkusen, University Hospital of Cologne, Cologne, Germany. adamek@klinikum-lev.de
Henning Ernst
HE
Adamek
Walburga
W
Schantzen
Ulf
U
Rinas
Matthias
M
Goyen
Waled
W
Ajaj
Christina
C
Esser
D000293:Adolescent; D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult