title: Outcomes of computed tomography and magnetic resonance enterography in clinical practice of inflammatory bowel disease.
abstract: BACKGROUND
  Computed tomography (CT) and magnetic resonance (MR) enterography are now widely used to diagnose and monitor Crohn's disease.
  
  
  OBJECTIVE
  We sought to assess the use of enterography for management of inflammatory bowel disease (IBD) in our medical center.
  
  
  METHODS
  We performed a retrospective review of all patients diagnosed with IBD who underwent MR or CT enterography from November 1, 2010 to October 25, 2012 at our institution. We assessed disease complications identified by enterography, agreement between disease activity determined by endoscopy and enterography, association between inflammatory markers and enterography-determined disease activity and recommended changes in medical and surgical management following enterography.
  
  
  RESULTS
  A total of 311 enterography studies (291 MR and 20 CT enterographies) were performed on 270 patients, including 258 (83.0 %) on patients with presumed Crohn's disease and 53 (17.0 %) with presumed ulcerative colitis. Active small bowel (SB) disease was noted in 73/311 (23.5 %) studies. Complications including strictures, perianal fistulas, abscesses and SB fistulas were noted in 108/311 (34.7 %) studies. Endoscopic and enterography defined active disease had an agreement of κ = 0.36 in the ileum (n = 179). A total of 142/311 (45.7 %) enterographies were associated with recommended medication changes within 90 days while surgery or endoscopic dilation of stricture was recommended following 41/311 (13.2 %) enterographies. Enterography resulted in a change in diagnosis from ulcerative colitis to Crohn's in 5/311 (1.6 %) studies.
  
  
  CONCLUSIONS
  Enterography reveals active disease and complications not evident on endoscopy and should be considered in the initial diagnosis, assessment of disease activity, and monitoring of therapy in patients with IBD.
authors: Department of Medicine, University of California San Diego, La Jolla, CA, USA, nip002@ucsd.edu.
authors: Niraj S
authors: NS
authors: Patel
authors: Suresh
authors: S
authors: Pola
authors: Ramya
authors: R
authors: Muralimohan
authors: G Y
authors: GY
authors: Zou
authors: Cynthia
authors: C
authors: Santillan
authors: Derek
authors: D
authors: Patel
authors: Barrett G
authors: BG
authors: Levesque
authors: William J
authors: WJ
authors: Sandborn
mesh_terms: D000328:Adult; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed