title: Prediction of patency capsule retention in known Crohn's disease patients by using magnetic resonance imaging.
abstract: OBJECTIVE
  Evaluation of small-bowel patency is recommended before swallowing video capsule endoscopy to prevent capsule retention. This study aimed to evaluate the ability of magnetic resonance enterography (MRE) to predict patency capsule (PC) retention in patients with Crohn's disease and to identify the most predictive imaging features for retention.
  
  
  METHODS
  Fifty-seven patients prospectively underwent MRE and PC. Two radiologists predicted PC retention. Interrater reliability was determined by using Cohen's κ coefficient. The sensitivity, specificity, and positive and negative predictive values were calculated for the predictions. Evaluation of the imaging features was done using the t test and receiver-operating characteristics; t-tests were also performed on the clinical parameters.
  
  
  RESULTS
  The κ value for interrater reliability was 0.58. The sensitivity, specificity, PPV, and NPV for the predictions by the 2 radiologists were 92.3%, 59%, 40%, 96.3%, and 100%, 52.3%, 38.2%, 100%, respectively. The maximal stricture length (9.7 ± 3.66 cm vs 7.0 ± 3.08 cm, P = .04) and the number of prestenotic dilations (1.9 ± 1.07 vs 1.0 ± 1.38, P = .03) were associated with PC retention. The area under the receiver-operating characteristic curves was 0.69 for the maximal stricture length and 0.751 for the number of prestenotic dilations. The phenotype of the disease was the only clinical parameter significantly correlated with PC retention.
  
  
  CONCLUSIONS
  MRE has a high NPV and sensitivity for PC retention. When capsule retention is suggested by MRE, PC should be performed before the video capsule endoscopy examination. The maximal stricture length and the number of prestenotic dilations were found to be the most predictive imaging features for PC retention.
authors.affiliation: Department of Radiology, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Noa
authors.initials: N
authors.lastname: Rozendorn
authors.affiliation: Department of Radiology, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Klang
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Adi
authors.initials: A
authors.lastname: Lahat
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Yablecovitch
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Kopylov
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Abraham
authors.initials: A
authors.lastname: Eliakim
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Shomron
authors.initials: S
authors.lastname: Ben-Horin
authors.affiliation: Department of Radiology, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Michal Marianne
authors.initials: MM
authors.lastname: Amitai
mesh_terms: D000328:Adult; D053705:Capsule Endoscopes; D053704:Capsule Endoscopy; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000473:pathology; D003424:Crohn Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult