Abstract
Background: The diagnosis of small bowel Crohn's disease (CD) is performed by ileocolonoscopy, whereas the assessment of its extension can be achieved by radiologic studies or, noninvasively, by magnetic resonance (MR) enterography and bowel sonography (BS). However, few comparative studies exist directly comparing the diagnostic accuracy of BS and MRI. The aim of this study was to evaluate the diagnostic accuracy of BS and MRI for the diagnosis of small bowel CD. Methods: We prospectively performed a noninferiority diagnostic study including 234 consecutive subjects with suspected small bowel CD. All patients underwent IC (used as gold standard for diagnosis), BS, and MR enterography performed in random order by physicians who were blinded about the results. Results: The diagnosis of small bowel CD was made in 120 of 249 subjects (48%). Sensitivity, specificity, positive predictive value, and negative predictive value for CD diagnosis were 94%, 97%, 97%, and 94% for BS and 96%, 94%, 94%, and 96% for MR enterography, respectively. BS was less accurate than MR enterography in defining CD extension (r = 0.69), whereas the concordance in terms of CD location between the 2 procedures was high (k = 0.81). Also, MRI showed a fair concordance with BS about strictures (k = 0.82) and abscesses (k = 0.88), with better detection of enteroenteric fistulas (k = 0.67). Conclusions: BS and MR enterography are 2 accurate procedures for the diagnosis of small bowel CD, although MR seems to be more sensitive in defining its extension. BS could be used to select the patients for subsequent MRI examination.
| Original language | English |
|---|---|
| Pages (from-to) | 991-998 |
| Number of pages | 8 |
| Journal | Inflammatory Bowel Diseases |
| Volume | 19 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Mar 2013 |
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Keywords
- Bowel sonography
- Crohn
- Enterography
- Inflammatory bowel disease
- MRI
ASJC Scopus subject areas
- Gastroenterology
- Immunology and Allergy
Cite this
Noninvasive diagnosis of small bowel crohn's disease : Direct comparison of bowel sonography and magnetic resonance enterography. / Castiglione, Fabiana; Mainenti, Pier Paolo; De Palma, Giovanni Domenico; Testa, Anna; Bucci, Luigi; Pesce, Giuseppe; Camera, Luigi; Diaferia, Maria; Rea, Matilde; Caporaso, Nicola; Salvatore, Marco; Rispo, Antonio.
In: Inflammatory Bowel Diseases, Vol. 19, No. 4, 03.2013, p. 991-998.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Noninvasive diagnosis of small bowel crohn's disease
T2 - Direct comparison of bowel sonography and magnetic resonance enterography
AU - Castiglione, Fabiana
AU - Mainenti, Pier Paolo
AU - De Palma, Giovanni Domenico
AU - Testa, Anna
AU - Bucci, Luigi
AU - Pesce, Giuseppe
AU - Camera, Luigi
AU - Diaferia, Maria
AU - Rea, Matilde
AU - Caporaso, Nicola
AU - Salvatore, Marco
AU - Rispo, Antonio
PY - 2013/3
Y1 - 2013/3
N2 - Background: The diagnosis of small bowel Crohn's disease (CD) is performed by ileocolonoscopy, whereas the assessment of its extension can be achieved by radiologic studies or, noninvasively, by magnetic resonance (MR) enterography and bowel sonography (BS). However, few comparative studies exist directly comparing the diagnostic accuracy of BS and MRI. The aim of this study was to evaluate the diagnostic accuracy of BS and MRI for the diagnosis of small bowel CD. Methods: We prospectively performed a noninferiority diagnostic study including 234 consecutive subjects with suspected small bowel CD. All patients underwent IC (used as gold standard for diagnosis), BS, and MR enterography performed in random order by physicians who were blinded about the results. Results: The diagnosis of small bowel CD was made in 120 of 249 subjects (48%). Sensitivity, specificity, positive predictive value, and negative predictive value for CD diagnosis were 94%, 97%, 97%, and 94% for BS and 96%, 94%, 94%, and 96% for MR enterography, respectively. BS was less accurate than MR enterography in defining CD extension (r = 0.69), whereas the concordance in terms of CD location between the 2 procedures was high (k = 0.81). Also, MRI showed a fair concordance with BS about strictures (k = 0.82) and abscesses (k = 0.88), with better detection of enteroenteric fistulas (k = 0.67). Conclusions: BS and MR enterography are 2 accurate procedures for the diagnosis of small bowel CD, although MR seems to be more sensitive in defining its extension. BS could be used to select the patients for subsequent MRI examination.
AB - Background: The diagnosis of small bowel Crohn's disease (CD) is performed by ileocolonoscopy, whereas the assessment of its extension can be achieved by radiologic studies or, noninvasively, by magnetic resonance (MR) enterography and bowel sonography (BS). However, few comparative studies exist directly comparing the diagnostic accuracy of BS and MRI. The aim of this study was to evaluate the diagnostic accuracy of BS and MRI for the diagnosis of small bowel CD. Methods: We prospectively performed a noninferiority diagnostic study including 234 consecutive subjects with suspected small bowel CD. All patients underwent IC (used as gold standard for diagnosis), BS, and MR enterography performed in random order by physicians who were blinded about the results. Results: The diagnosis of small bowel CD was made in 120 of 249 subjects (48%). Sensitivity, specificity, positive predictive value, and negative predictive value for CD diagnosis were 94%, 97%, 97%, and 94% for BS and 96%, 94%, 94%, and 96% for MR enterography, respectively. BS was less accurate than MR enterography in defining CD extension (r = 0.69), whereas the concordance in terms of CD location between the 2 procedures was high (k = 0.81). Also, MRI showed a fair concordance with BS about strictures (k = 0.82) and abscesses (k = 0.88), with better detection of enteroenteric fistulas (k = 0.67). Conclusions: BS and MR enterography are 2 accurate procedures for the diagnosis of small bowel CD, although MR seems to be more sensitive in defining its extension. BS could be used to select the patients for subsequent MRI examination.
KW - Bowel sonography
KW - Crohn
KW - Enterography
KW - Inflammatory bowel disease
KW - MRI
UR - http://www.scopus.com/inward/record.url?scp=84876383441&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84876383441&partnerID=8YFLogxK
U2 - 10.1097/MIB.0b013e3182802b87
DO - 10.1097/MIB.0b013e3182802b87
M3 - Article
C2 - 23429465
AN - SCOPUS:84876383441
VL - 19
SP - 991
EP - 998
JO - Inflammatory Bowel Diseases
JF - Inflammatory Bowel Diseases
SN - 1078-0998
IS - 4
ER -