title: Accuracy of magnetic resonance enterography in the preoperative assessment of patients with Crohn's disease of the small bowel.
abstract: OBJECTIVE
  To assess the accuracy of magnetic resonance enterography in predicting the extension, location and characteristics of the small bowel segments affected by Crohn's disease.
  
  
  METHODS
  This is a prospective study including a consecutive series of 38 patients with Crohn's disease of the small bowel who underwent surgery at a specialized colorectal unit of a tertiary hospital. Preoperative magnetic resonance enterography was performed in all patients, following a homogeneous protocol, within the 3 months prior to surgery. A thorough exploration of the small bowel was performed during the surgical procedure; calibration spheres were used according to the discretion of the surgeon. The accuracy of magnetic resonance enterography in detecting areas affected by Crohn's disease in the small bowel was assessed. The findings of magnetic resonance enterography were compared with surgical and pathological findings.
  
  
  RESULTS
  Thirty-eight patients with 81 lesions were included in the study. During surgery, 12 lesions (14.8%) that were not described on magnetic resonance enterography were found. Seven of these were detected exclusively by the use of calibration spheres, passing unnoticed at surgical exploration. Magnetic resonance enterography had 90% accuracy in detecting the location of the stenosis (75.0% sensitivity, 95.7% specificity). Magnetic resonance enterography did not precisely diagnose the presence of an inflammatory phlegmon (accuracy 46.2%), but it was more accurate in detecting abscesses or fistulas (accuracy 89.9% and 98.6%, respectively).
  
  
  CONCLUSIONS
  Magnetic resonance enterography is a useful tool in the preoperative assessment of patients with Crohn's disease. However, a thorough intra-operative exploration of the entire small bowel is still necessary.
authors.affiliation: Department of General Surgery, Colorectal Unit, La Fe University Hospital, Valencia, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Pous-Serrano
authors.affiliation: Department of General Surgery, Colorectal Unit, La Fe University Hospital, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Frasson
authors.affiliation: Department of General Surgery, Colorectal Unit, La Fe University Hospital, Valencia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Palasí Giménez
authors.affiliation: Department of Radiology, La Fe University Hospital, Valencia, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Sanchez-Jordá
authors.affiliation: Department of Radiology, La Fe University Hospital, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Pamies-Guilabert
authors.affiliation: Department of Pathology, La Fe University Hospital, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Llavador Ros
authors.affiliation: Department of Gastroenterology, Inflammatory Bowel Disease Unit, La Fe University Hospital, Valencia, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Nos Mateu
authors.affiliation: Department of General Surgery, Colorectal Unit, La Fe University Hospital, Valencia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Garcia-Granero
mesh_terms: D000293:Adolescent; D000328:Adult; D002138:Calibration; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Crohn's Disease; calibration spheres; magnetic resonance enterography; preoperative assessment; small bowel; surgical treatment