title: Diagnosis of Small-Bowel Diseases: Prospective Comparison of Multi-Detector Row CT Enterography with MR Enterography.
abstract: OBJECTIVE
  To prospectively compare the accuracies of computed tomographic (CT) enterography and magnetic resonance (MR) enterography for the detection and characterization of small-bowel diseases.
  
  
  METHODS
  The institutional review board approved the study protocol, and informed consent was obtained from all participants. From June 2009 to July 2013, 150 consecutive patients (81 men and 69 women; mean age, 38.8 years; range, 18-74 years), who were suspected of having a small-bowel disease on the basis of clinical findings and whose previous upper and lower gastrointestinal endoscopy findings were normal, underwent CT and MR enterography. Two independent readers reviewed CT and MR enterographic images for the presence of small-bowel diseases, for differentiating between inflammatory and noninflammatory diseases, and for extraenteric complications. The histopathologic findings of surgical (n = 23) and endoscopic (n = 32) biopsy specimens were used as the reference standard; the results of video-capsule endoscopy (n = 36) and clinical follow-up (n = 59) were used only to confirm the absence of small-bowel disease.
  
  
  RESULTS
  MR and CT enterography were successfully performed in all 150 patients. Overall sensitivity, specificity, and accuracy, respectively, in identifying patients with small-bowel lesions were 75.9% (41 of 54), 94.8% (91 of 96), and 88.0% (132 of 150) for CT enterography and 92.6% (50 of 54), 99.0% (95 of 96), and 96.7% (145 of 150) for MR enterography. The sensitivity of MR enterography was significantly higher than that of CT enterography for the detection of both overall small-bowel diseases (P = .0159) and neoplastic diseases (P = .0412) but not for the detection of inflammatory diseases (P > .99) or noninflammatory and nonneoplastic diseases (P = .6171).
  
  
  CONCLUSIONS
  MR enterography is more accurate than CT enterography in the detection of small-bowel diseases; MR enterography was more accurate in detecting neoplastic diseases in particular.
authors.affiliation: From the Department of Radiology (G.M., E.C., E.P., F.L., R.M., G.G.), Department of Internal Medicine and Medical Specialities (M.D.T.), and Department of General and Special Surgery (M.G.B.), Umberto I Hospital Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Masselli
authors.affiliation: From the Department of Radiology (G.M., E.C., E.P., F.L., R.M., G.G.), Department of Internal Medicine and Medical Specialities (M.D.T.), and Department of General and Special Surgery (M.G.B.), Umberto I Hospital Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Di Tola
authors.affiliation: From the Department of Radiology (G.M., E.C., E.P., F.L., R.M., G.G.), Department of Internal Medicine and Medical Specialities (M.D.T.), and Department of General and Special Surgery (M.G.B.), Umberto I Hospital Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Casciani
authors.affiliation: From the Department of Radiology (G.M., E.C., E.P., F.L., R.M., G.G.), Department of Internal Medicine and Medical Specialities (M.D.T.), and Department of General and Special Surgery (M.G.B.), Umberto I Hospital Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Polettini
authors.affiliation: From the Department of Radiology (G.M., E.C., E.P., F.L., R.M., G.G.), Department of Internal Medicine and Medical Specialities (M.D.T.), and Department of General and Special Surgery (M.G.B.), Umberto I Hospital Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Laghi
authors.affiliation: From the Department of Radiology (G.M., E.C., E.P., F.L., R.M., G.G.), Department of Internal Medicine and Medical Specialities (M.D.T.), and Department of General and Special Surgery (M.G.B.), Umberto I Hospital Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Monti
authors.affiliation: From the Department of Radiology (G.M., E.C., E.P., F.L., R.M., G.G.), Department of Internal Medicine and Medical Specialities (M.D.T.), and Department of General and Special Surgery (M.G.B.), Umberto I Hospital Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Bernieri
authors.affiliation: From the Department of Radiology (G.M., E.C., E.P., F.L., R.M., G.G.), Department of Internal Medicine and Medical Specialities (M.D.T.), and Department of General and Special Surgery (M.G.B.), Umberto I Hospital Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Gualdi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D053704:Capsule Endoscopy; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis*; D007421:Intestine, Small; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*