title: Comparison of magnetic resonance and balloon enteroscopic examination of the small intestine in patients with Crohn's disease.
abstract: OBJECTIVE
  Magnetic resonance (MR) enterography is a recommended imaging technique for detecting intestinal involvement in Crohn's disease (CD). However, the diagnostic accuracy of MR enterography has not been compared directly what that of enteroscopy of the jejunum and proximal ileum. We evaluated the usefulness of MR enterocolonography (MREC) by comparing its findings with those from balloon-assisted enteroscopy.
  
  
  METHODS
  In a prospective study, MREC and enteroscopy were performed within 3 days of each other on 100 patients. Ulcerative lesions and all mucosal lesions were evaluated. Physicians and radiologists were blinded to results from other studies. Findings from MREC were compared directly with those from enteroscopy; the sensitivity and specificity with which MREC detected CD lesions were assessed.
  
  
  RESULTS
  MREC detected ulcerative lesions and all mucosal lesions in the small intestine with 82.4% sensitivity (95% confidence interval [CI], 75.4%-87.7%) and 67.5% sensitivity (95% CI, 63.1%-70.0%); specificity values were 87.6% (95% CI, 83.7%-90.6%) and 94.8% (95% CI, 90.1%-97.5%). MREC detected major stenosis with 58.8% sensitivity (95% CI, 37.6%-77.2%) and 90.0% specificity (95% CI, 88.4%-91.5%) and all stenoses with 40.8% sensitivity (95% CI, 30.8%-49.4%) and 93.7% specificity (95% CI, 91.1%-95.9%).
  
  
  CONCLUSIONS
  MREC is useful for detecting active lesions in the small intestine. However, MR imaging is less sensitive for detecting intestinal damage, such as stenoses. Enteroscopy is preferred for identifying intestinal damage. Suitable imaging approaches should be selected to assess CD lesions in deep small intestine.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kento
authors.initials: K
authors.lastname: Takenaka
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ohtsuka
authors.affiliation: Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kitazume
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Nagahori
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Eiko
authors.initials: E
authors.lastname: Saito
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Naganuma
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Araki
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: mamoru.gast@tmd.ac.jp.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D058582:Double-Balloon Enteroscopy; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D014456:Ulcer / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult
keywords: Diagnosis; IBD; Intestinal Damage; Ulcer