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Evaluating the diagnostic accuracy of magnetic resonance imaging in distinguishing strictures in Crohn’s disease: a systematic review and meta-analysis

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Abstract

Purpose

This systematic review and meta-analysis sought to assess the diagnostic accuracy of magnetic resonance imaging (MRI) in distinguishing fibrotic from inflammatory strictures in Crohn’s disease (CD) patients.

Methods

A rigorous and systematic exploration of five key databases yielded studies that met predefined criteria. Data were extracted for a comprehensive meta-analysis using MetaDiSC and MetaDTA software, providing diagnostic accuracy measures. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was utilized for evaluating the methodological quality and potential bias within the studies.

Results

The systematic review involved the evaluation of 7437 records, culminating in the inclusion of 22 studies. In detecting fibrotic strictures in CD patients, MRI exhibited a pooled sensitivity of 85.20% (95% CI: 76.10–91.20%) and specificity of 96.00% (95% CI: 87.80–98.70%). For differentiating fibrotic strictures from inflammatory stenosis, the sensitivity was 81.5% (95% CI: 70.2–89.20%), and the specificity was 97.2% (95% CI: 90.0–99.3%). In terms of assessing the severity of strictures, sensitivity stood at 90.4% (95% CI: 78.1–96.1%) and specificity at 89.4% (95% CI: 57.4–98.2%). The consistency of the diagnostic accuracy was observed across different geographical locations and the various reference tests applied in the studies.

Conclusions

The results of this meta-analysis underscore the robust diagnostic accuracy of MRI in detecting fibrotic strictures, distinguishing between fibrotic and inflammatory strictures, and evaluating stricture severity in CD patients. These findings support the integration of MRI into standard diagnostic protocols for patients with CD. Further large-scale, multicenter trials are warranted to confirm these results and to identify any potential limitations associated with the application of MRI in this clinical setting.

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Data availability

The data evaluated were derived from published articles and the estimates are shown in the forest plots.

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Author information

Authors and Affiliations

  1. Department of Gastroenterology, The University of Toledo, Toledo, OH, 43606, USA

    Abdallah Kobeissy, Zohaib Ahmed, Mona Hassan & Yaseen Alastal

  2. Department of Internal Medicine, The University of Toledo, Toledo, OH, 43606, USA

    Nooraldin Merza

  3. College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, 43606, USA

    Yusuf Nawras

  4. Department of Internal Medicine, Al Azhar University, New Damietta, Egypt

    Eshak I. Bahbah

  5. Gastroenterology Department, Corewell Health/Willam Beaumont University Hospital, Royal Oak, MI, 48073, USA

    Alsadiq Al-Hillan

Authors
  1. Abdallah Kobeissy
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  2. Nooraldin Merza
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  7. Mona Hassan
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Contributions

Abdallah Kobeissy, Nooraldin Merza, Yusuf Nawras, Mona Hassan, and Zohaib Ahmed conceptualized the study, drafted the initial manuscript, conducted the database search and data extraction, and assisted in the meta-analysis and result interpretation. Eshak I. Bahbah and Alsadiq Al-Hillan reviewed the methodology, ensured research accuracy and integrity, and contributed to the study’s quality assessment. Yaseen Alastal managed project logistics and finalized the review of the manuscript. All authors reviewed, approved, and contributed significantly to the final submission.

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Correspondence to Nooraldin Merza.

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Kobeissy, A., Merza, N., Nawras, Y. et al. Evaluating the diagnostic accuracy of magnetic resonance imaging in distinguishing strictures in Crohn’s disease: a systematic review and meta-analysis. Int J Colorectal Dis 38, 258 (2023). https://doi.org/10.1007/s00384-023-04544-0

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