Abstract
Background
Computed tomography (CT) and magnetic resonance (MR) enterography are now widely used to diagnose and monitor Crohn’s disease.
Aim
We sought to assess the use of enterography for management of inflammatory bowel disease (IBD) in our medical center.
Methods
We performed a retrospective review of all patients diagnosed with IBD who underwent MR or CT enterography from November 1, 2010 to October 25, 2012 at our institution. We assessed disease complications identified by enterography, agreement between disease activity determined by endoscopy and enterography, association between inflammatory markers and enterography-determined disease activity and recommended changes in medical and surgical management following enterography.
Results
A total of 311 enterography studies (291 MR and 20 CT enterographies) were performed on 270 patients, including 258 (83.0 %) on patients with presumed Crohn’s disease and 53 (17.0 %) with presumed ulcerative colitis. Active small bowel (SB) disease was noted in 73/311 (23.5 %) studies. Complications including strictures, perianal fistulas, abscesses and SB fistulas were noted in 108/311 (34.7 %) studies. Endoscopic and enterography defined active disease had an agreement of κ = 0.36 in the ileum (n = 179). A total of 142/311 (45.7 %) enterographies were associated with recommended medication changes within 90 days while surgery or endoscopic dilation of stricture was recommended following 41/311 (13.2 %) enterographies. Enterography resulted in a change in diagnosis from ulcerative colitis to Crohn’s in 5/311 (1.6 %) studies.
Conclusion
Enterography reveals active disease and complications not evident on endoscopy and should be considered in the initial diagnosis, assessment of disease activity, and monitoring of therapy in patients with IBD.
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Conflict of interest
Cynthia Santillan—Consulting at Robarts Clinical Research. Barrett Levesque—Consulting at Santarus, Prometheus Labs, Castlight Health as well as speaking and teaching at Warner Chilcott, Salix, UCB Pharma, Abbott Labs. William Sandborn has no conflicts relevant to this study. Suresh Pola, Niraj S. Patel, Ramya Muralimohan, Guangyong Zou, and Derek Patel have nothing to disclose.
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Niraj S. Patel and Suresh Pola are co first-authors.
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Patel, N.S., Pola, S., Muralimohan, R. et al. Outcomes of Computed Tomography and Magnetic Resonance Enterography in Clinical Practice of Inflammatory Bowel Disease. Dig Dis Sci 59, 838–849 (2014). https://doi.org/10.1007/s10620-013-2964-7
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DOI: https://doi.org/10.1007/s10620-013-2964-7