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Assessment of Crohn’s disease in the small bowel: prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis

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Abstract

Our objective was to assess the diagnostic value of magnetic resonance enteroclysis (MRE) compared with conventional enteroclysis (CE) in patients with Crohn’s disease. A secondary objective was to evaluate the diagnostic accuracy of each different MR sequence. Sixty-six consecutive patients with known Crohn’s disease underwent MRE and CE. Fast imaging employing steady-state acquisition (FIESTA), single-shot fast spin-echo (ssFSE), and contrast-enhanced T1-weighted sequences were assessed by two radiologists who reached a consensus about the following findings: visualization of wall ulcers, pseudopolyps, fistulae, mural stenosis, and mesenteric abnormalities. Standard descriptive statistics and the McNemar test were used. The sensitivity, specificity and accuracy of MRE were 90–87% and 83% for the depiction of parietal ulcers, 84%–88% and 86% for pseudopolyps, 100–94% and 96% for mural stenosis, 93–100% and 94% for fistulae. The number of detected extraluminal findings was significantly higher with MRE (P<0.01). The accuracy of FIESTA sequence was statistically higher in the depiction of wall ulcers and fistulae than that of three-dimensional fast spoiled gradient echo (3D-FSPGR) (P<0.01) and ssFSE (P<0.05) sequences. Contrast-enhanced 3D-FSPGR was superior for mural stenosis visualization compared to ssFSE (P<0.05) and FIESTA (P<0.05). MRE correlates accurately with CE in the detection of superficial and transmural abnormalities and has the advantage of assessing the mesenteric manifestations.

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Authors and Affiliations

  1. Radiology DEA Department, Umberto I Academic Hospital, University La Sapienza, Viale del Policlinico, 155-00161, Rome, Italy

    Gabriele Masselli, Emanuele Casciani, Elisabetta Polettini, Silvia Lanciotti, Luca Bertini & Gianfranco Gualdi

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  1. Gabriele Masselli
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  2. Emanuele Casciani
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  3. Elisabetta Polettini
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  4. Silvia Lanciotti
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  5. Luca Bertini
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  6. Gianfranco Gualdi
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Correspondence to Gabriele Masselli.

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Masselli, G., Casciani, E., Polettini, E. et al. Assessment of Crohn’s disease in the small bowel: prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis. Eur Radiol 16, 2817–2827 (2006). https://doi.org/10.1007/s00330-006-0338-7

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  • DOI: https://doi.org/10.1007/s00330-006-0338-7

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