Magnetic resonance enterocolonography in detecting erosion and redness in intestinal mucosa of patients with Crohn's disease.
OBJECTIVE
In Crohn's disease (CD), assessment of disease activity and extension is important for clinical management. Endoscopy is the most reliable tool for evaluating disease activity in these patients and it distinguishes between lesions based on ulcer, erosion, and redness. Magnetic resonance imaging (MRI) is less invasive than endoscopy; however, the sensitivity of MRI in detecting lesions is believed to be lower, and whether MRI can detect milder lesions has not been studied. The aim of this study was to compare the detection ability of magnetic resonance enterocolonography (MREC) with ileocolonic endoscopy in patients with CD.


METHODS
A total of 27 patients with CD underwent both MREC and ileocolonoscopy. There were 55 lesions (18 ileum and 37 colon) endoscopically detected, and the findings of MREC were compared with each ileocolonoscopic finding to determine sensitivity and specificity.


RESULTS
For a positive lesion defined as having at least one of the following: wall thickness, edema, diffusion-weighted imaging (DWI) high intensity and relative contrast enhancement (RCE) on MREC, the sensitivities were 100% for ulcer, 84.6% for erosion, and 52.9% for redness, suggesting an ability to detect milder lesions such as erosion or redness. Moreover, RCE values were well correlated with the severity of endoscopically identified active lesions.


CONCLUSIONS
MREC findings may be useful not only for evaluation of ulcers, but also for detection of endoscopically identified milder lesions in CD, suggesting a clinical usefulness of MREC for disease detection and monitoring.
Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Hirokazu
H
Sato
Chiharu
C
Tamura
Kazuyuki
K
Narimatsu
Motonori
M
Shimizu
Takeshi
T
Takajyo
Masataka
M
Yamashita
Yasushi
Y
Inoue
Hayato
H
Ozaki
Hirotaka
H
Furuhashi
Koji
K
Maruta
Yuichi
Y
Yasutake
Kenichi
K
Yoshikawa
Chikako
C
Watanabe
Shunsuke
S
Komoto
Kengo
K
Tomita
Shigeaki
S
Nagao
Soichiro
S
Miura
Hiroshi
H
Shinmoto
Ryota
R
Hokari
D000293:Adolescent; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
Crohn's disease; MR enterocolonography; colonic inflammation; endoscopy