title: Impact of magnetic resonance enterography in the management of small bowel Crohn's disease.
abstract: BACKGROUND
  Magnetic resonance enterography (MRE) is a relatively new imaging modality that involves small bowel distension with orally administered fluid. Few studies have assessed its impact on patient management.
  
  
  OBJECTIVE
  The aim of this study was to determine whether MRE influenced the management of patients with established small bowel Crohn's disease (CD).
  
  
  METHODS
  From a prospectively maintained database of patients with inflammatory bowel disease, we identified patients with small bowel CD who underwent MRE between January 2007 and December 2010. The results of the MRE and subsequent changes in patient management within 1 month were evaluated.
  
  
  RESULTS
  Thirty women and 27 men with CD were included. Seven patients (12%) had a normal MRE. Forty-two of 57 (74%) patients had a change in management, and 41/50 (82%) patients with an abnormal MRE had changes in management (P<0.0008). After MRE, 20/42 (47%) patients had surgery and 22/42 (53%) had changes in medical treatment. Patients with stricturing disease had more surgical intervention (P=0.02), and patients with active disease on MRE had more medical intervention (P=0.0001). Patients with two or more abnormalities on MRE had more surgery compared with medical therapy (P=0.02).
  
  
  CONCLUSIONS
  The majority of patients with small bowel CD had a change in management as a result of the MRE. Because of its high clinical impact on patient management, MRE should become one of the preferred methods of small bowel evaluation in CD. Specific MRE findings may help to stratify treatment options, however, further work is required to validate this.
authors: Department of Gastroenterology Hospital, St Vincent's University Hospital, Centre for Colorectal Disease, Dublin, Ireland. dgcheriyan@gmail.com
authors: Danny G
authors: DG
authors: Cheriyan
authors: Eoin
authors: E
authors: Slattery
authors: Shaunagh
authors: S
authors: McDermott
authors: Aoife
authors: A
authors: Kilcoyne
authors: Craig
authors: C
authors: Kingston
authors: Denise
authors: D
authors: Keegan
authors: Hugh E
authors: HE
authors: Mulcahy
authors: Glen A
authors: GA
authors: Doherty
authors: Dermot E
authors: DE
authors: Malone
authors: Seamus J
authors: SJ
authors: Murphy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult