title: Accuracy of imaging for predicting operative approach in Crohn's disease.
abstract: BACKGROUND
  The aim of this study was to assess the accuracy of preoperative imaging in detecting the extent of disease and predicting the operative approach in patients with Crohn's disease.
  
  
  METHODS
  Patients with Crohn's disease who were scheduled to undergo operation were evaluated before operation using computed tomography enteroclysis (CTE) and magnetic resonance enterography (MRE). Preoperative imaging findings were correlated with intraoperative and pathological findings to estimate the capabilities of preoperative imaging in detecting lesions due to Crohn's disease. The operative approach determined before surgery was compared with the procedure actually performed, which was based on intraoperative findings.
  
  
  RESULTS
  Fifty-two patients with Crohn's disease were studied; 26 were evaluated before surgery with CTE and 26 with MRE. Eighty-nine lesions due to Crohn's disease were confirmed surgically (60 small bowel stenoses, 21 fistulas and 8 abscesses). CTE confirmed the presence of 38 of 41 lesions (sensitivity 93 per cent) and MRE 48 of 48 lesions (sensitivity 100 per cent); a correct estimation of the disease with an exact prediction of the operative approach was obtained in 49 (94 per cent) of 52 patients. Discrepant findings between preoperative imaging and operative findings were observed in three patients (6 per cent), who had CTE.
  
  
  CONCLUSIONS
  Preoperative imaging using CTE or MRE is highly accurate for assessing Crohn's disease lesions before operation, allowing correct prediction of the operative approach.
authors.affiliation: Department of Digestive Diseases, Hôpital Lariboisière Assistance Publique-Hôpitaux de Paris, France. bricemalgras@hotmail.com
authors.forename: B
authors.initials: B
authors.lastname: Malgras
authors.forename: P
authors.initials: P
authors.lastname: Soyer
authors.forename: M
authors.initials: M
authors.lastname: Boudiaf
authors.forename: M
authors.initials: M
authors.lastname: Pocard
authors.forename: A
authors.initials: A
authors.lastname: Lavergne-Slove
authors.forename: P
authors.initials: P
authors.lastname: Marteau
authors.forename: P
authors.initials: P
authors.lastname: Valleur
authors.forename: K
authors.initials: K
authors.lastname: Pautrat
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002432:Cecum / Q000601:surgery; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D003424:Crohn Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007079:Ileitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007082:Ileum / Q000601:surgery; D007579:Jejunal Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D012015:Reference Standards; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards*; D055815:Young Adult