title: MR enterography: relationship between intestinal fold pattern and the clinical presentation of adult celiac disease.
abstract: OBJECTIVE
  To correlate the clinical presentation of adult celiac disease with various intestinal fold patterns using MR-enterography.
  
  
  METHODS
  Fifty-four consecutive adult celiac patients (34 female, 20 male, 18 to 62 years) were studied by MR-enterography. Two radiologists blinded to the patients' clinical history evaluated in consensus MR studies, classifying the intestinal fold pattern into four categories: (a) no fold abnormalities, (b) isolated loss of folds in the duodenum, (c) jejunization of ileum, and (d) jejuno-ileal fold pattern reversal. Patients presented with the varying clinical forms of Celiac disease, classified as: (i) typical disease, (ii) atypical disease, and (iii) silent form.
  
  
  RESULTS
  Twenty-three patients showed no intestinal fold abnormalities; 11 patients had isolated loss of duodenal folds; 9 patients showed jejunization of ileum and 11 had jejuno-ileal fold pattern reversal. 18/23 (78%) patients with MRI normal fold pattern had the silent clinical form of Celiac disease (Sensitivity 78%; specificity 100%; PPV = 1, NPV = 0.78); 9/11 (82%) patients with the isolated loss of duodenal folds had the atypical clinical form (sensitivity 82%; and specificity 100%; PPV = 1; NPV = 0.82). All 20 patients with the jejunization of ileum and jejuno-ileal fold pattern reversal had typical celiac disease (sensitivity and specificity of 100%; PPV and NPV = 1).
  
  
  CONCLUSIONS
  MR-enterography findings in patients with celiac disease, demonstrates good correlation between MR findings and clinical severity.
authors.affiliation: Department of Radiology, University Sapienza of Rome, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Tomei
authors.forename: Daniele
authors.initials: D
authors.lastname: Diacinti
authors.forename: Andrea
authors.initials: A
authors.lastname: Stagnitti
authors.forename: Mario
authors.initials: M
authors.lastname: Marini
authors.forename: Andrea
authors.initials: A
authors.lastname: Laghi
authors.forename: Roberto
authors.initials: R
authors.lastname: Passariello
authors.forename: Richard C
authors.initials: RC
authors.lastname: Semelka
mesh_terms: D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000473:pathology*; D005260:Female; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D055815:Young Adult