title: Diagnostic accuracy of three different MRI protocols in patients with inflammatory bowel disease.
abstract: BACKGROUND
  Magnetic resonance imaging (MRI) is used for workup and control of inflammatory bowel disease (IBD); however, disagreement remains as to how the MRI should be performed.
  
  
  OBJECTIVE
  To compare prospectively the diagnostic accuracy of MRI with neither oral nor intravenous contrast medium (plain MRI), magnetic resonance follow-through (MRFT) and MR enteroclysis (MRE) using MRE as the reference standard in patients with inflammatory bowel disease.
  
  
  METHODS
  Plain MRI and MRE were carried out in addition to MRFT. All patients underwent both plain MR and MRFT on the same day and MRE within seven days. For the evaluation, the bowel was divided into nine segments. One radiologist, blinded to clinical findings, evaluated bowel wall thickness, diffusion weighted imaging (DWI), mural hyperenhancement, and other inflammatory changes in each bowel segment.
  
  
  RESULTS
  Twenty patients (6 men, 14 women; median age, 43.5 years; age range, 26-76 years) underwent all three examinations; 10 with Crohn's disease (CD), three with ulcerative colitis (UC), and seven with IBD unclassified (IBD-U). Sensitivity, specificity, and accuracy were in the range of 0-75%, 81-96%, and 75-95% for wall thickening, and 0-37%, 59-89%, and 50-86% for DWI in plain MRI, respectively. Sensitivity, specificity, and accuracy were in the range of 0-50%, 96-100%, and 90-100% for wall thickening, 0-50%, 84-97%, and 82-95% for DWI, and 0-71%, 94-100%, and 85-100% for mural hyperenhancement in MRFT, respectively.
  
  
  CONCLUSIONS
  The use of oral and intravenous contrast agent improves detection of bowel lesions resulting in MRFT remaining the superior choice over plain MRI for diagnostic workup in patients with IBD.
authors.affiliation: Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, Herlev, Denmark ; Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Kayalvily
authors.initials: K
authors.lastname: Jesuratnam-Nielsen
authors.affiliation: Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, Herlev, Denmark.
authors.forename: Vibeke Berg
authors.initials: VB
authors.lastname: Løgager
authors.affiliation: Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark ; DEEP - Danish Centre for eHealth & Epidemiology, North Zealand Hospital, University of Copenhagen, Denmark.
authors.forename: Pia
authors.initials: P
authors.lastname: Munkholm
authors.affiliation: Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, Herlev, Denmark ; Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henrik S
authors.initials: HS
authors.lastname: Thomsen
keywords: Crohn’s disease; inflammatory bowel disease; magnetic resonance enteroclysis (MRE); magnetic resonance follow-through (MRFT); magnetic resonance imaging (MRI); ulcerative colitis