Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: first year of experience.
OBJECTIVE
to describe the experience at two tertiary centres during the first year of use of magnetic resonance enterography (MRE) for the management of Crohn's disease (CD): indications and influence of the technique in clinical decision making.


METHODS
retrospective descriptive study in which patients who underwent MRE were included consecutively. Epidemiological and clinical data were collected from the patients, as well as the indication for the study and how it influenced clinical decision making in the 10 days following the radiological study.


RESULTS
24 MREs were performed in suspected CD and 126 known CD; partial bowel obstruction in 53 patients (42%), monitoring of medical treatment in 34 (27%), due to incomplete ileocolonoscopy in 16 (13%), extension study of the small intestine in 15 (12%) and suspected complicated CD in 8 patients (6%). The MRE influenced in a change in treatment in 83 (55.3%) patients: 16 (10.7%) started with immunosuppressants, 41 (27.3%) with anti-TNFα were started on or switched, 15 (10%) were ordered surgery and in 3 (2%) changed from combined therapy to monotherapy. The MRE had less influence on clinical decision making in the group in which the indication was suspected CD (p < 0.05).


CONCLUSIONS
the use of MRE helped on decision making in more than half of patients, especially with regards to decisions related to the use of biological therapies and the indication for surgery. MRE was less useful in suspected CD patients.
Department of Gastroenterology, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain.
Juan L
JL
Mendoza
Yago
Y
González-Lama
Carlos
C
Taxonera
Cristina
C
Suárez-Ferrer
Fátima
F
Matute
María I
MI
Vera
Natalia
N
López-Palacios
Pablo
P
Rodríguez
Marta
M
Calvo
Ramiro
R
Méndez
Miguel
M
Pastrana
Concepción
C
González
Raquel
R
Lana
Ricardo
R
Rodríguez
Luis
L
Abreu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003424:Crohn Disease / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D055815:Young Adult
D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha