title: Main Imaging Features of Crohn's Disease: Agreement between MR-Enterography and CT-Enterography.
abstract: BACKGROUND
  Only a few studies have compared the accuracy of magnetic resonance enterography (MRE) and computed tomography enterography (CTE) in the diagnosis of Crohn's disease and its complications.
  
  
  OBJECTIVE
  To compare the sensitivity of MRE and CTE analysis in their ability to detect, sign-by-sign, 10 classical imaging signs of Crohn's disease.
  
  
  METHODS
  The study group comprised 42 biopsy-proven Crohn's disease patients who underwent both CTE and MRE within an average period of 6 weeks. Agreement between the two modalities in detecting the 10 most significant radiological signs of CD was evaluated using the Kappa index. The sensitivity of MRE and CTE was calculated using a standard of reference composed of all the findings seen by CTE and/or MRE. We analyzed MRE and CTE sensitivity separately in two groups, according to the time interval between the examinations.
  
  
  RESULTS
  Agreement between CTE and MRE was more than 70% in 8 of the 10 signs: mural thickening, phlegmon, stenosis, skip lesions, mucosal stratification, fistula, abscess, and creeping fat. The Kappa level of agreement values for CTE versus MRE varied between substantial for phlegmon and skip lesions; moderate for fistula, creeping fat, abscess and mural thickening; and fair for stenosis and dilatation. CTE detected more findings than MRE, except for creeping fat and fistula. There was no significant difference in the sensitivity of CTE and MRE in the two groups defined by the time interval (time < 1.5 and time > 1.5 months) except for detection of dilatation.
  
  
  CONCLUSIONS
  Almost all imaging signs of Crohn's disease were detected equally well by both modalities regardless of the time interval between examinations. We therefore consider MRE to be reliable for imaging and follow-up in patients with Crohn's disease who may need recurrent imaging.
authors.forename: Michal M
authors.initials: MM
authors.lastname: Amitai
authors.forename: Lisa
authors.initials: L
authors.lastname: Raviv-Zilka
authors.forename: Marjorie
authors.initials: M
authors.lastname: Hertz
authors.forename: Zippora
authors.initials: Z
authors.lastname: Erlich
authors.forename: Eli
authors.initials: E
authors.lastname: Konen
authors.forename: Shomron
authors.initials: S
authors.lastname: Ben-Horin
authors.forename: Sara
authors.initials: S
authors.lastname: Apter
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000209:etiology; D000328:Adult; D057186:Comparative Effectiveness Research; D003251:Constriction, Pathologic / Q000175:diagnosis* / Q000209:etiology; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis; D004108:Dilatation, Pathologic / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis* / Q000209:etiology; D007422:Intestines / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D012680:Sensitivity and Specificity; D063189:Symptom Assessment / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods