A prospective randomized comparison between two MRI studies of the small bowel in Crohn's disease, the oral contrast method and MR enteroclysis

The aim was to compare bowel distension and diagnostic properties of magnetic resonance imaging of the small bowel with oral contrast (MRI per OS) with magnetic resonance enteroclysis (MRE). Forty patients with suspected Crohn's disease (CD) were examined with both MRI methods. MRI per OS was p...

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Bibliographic Details
Published in:European radiology 2007-09, Vol.17 (9), p.2294-2301
Main Authors: Negaard, Anne, Paulsen, Vemund, Sandvik, Leiv, Berstad, Audun Elnaes, Borthne, Arne, Try, Kirsti, Lygren, Idar, Storaas, Tryggve, Klow, Nils-Einar
Format: Article
Language:English
Subjects:
Administration, Oral
Adolescent
Adult
Contrast Media - administration & dosage
Crohn Disease - diagnosis
Female
Humans
Intestine, Small
Intubation, Gastrointestinal
Magnetic Resonance Imaging - methods
Male
Medical diagnosis
Middle Aged
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
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Summary:The aim was to compare bowel distension and diagnostic properties of magnetic resonance imaging of the small bowel with oral contrast (MRI per OS) with magnetic resonance enteroclysis (MRE). Forty patients with suspected Crohn's disease (CD) were examined with both MRI methods. MRI per OS was performed with a 6% mannitol solution and MRE with nasojejunal intubation and a polyethylenglycol solution. MRI protocol consisted of balanced fast field echo (B-FFE), T2 and T1 sequences with and without gadolinium. Two experienced radiologists individually evaluated bowel distension and pathological findings including wall thickness (BWT), contrast enhancement (BWE), ulcer (BWU), stenosis (BWS) and edema (EDM). The diameter of the small bowel was smaller with MRI per OS than with MRE (difference jejunum: 0.55 cm, p < 0.001; ileum: 0.35 cm, p < 0.001, terminal ileum: 0.09 cm, p = 0.08). However, CD was diagnosed with high diagnostic accuracy (sensitivity, specificity, positive and negative predictive values: MRI per OS 88%, 89%, 89%, 89%; MRE 88%, 84%, 82%, 89%) and inter-observer agreement (MRI per OS k = 0.95; MRE k = 1). In conclusion, bowel distension was inferior in MRI per OS compared to MRE. However, both methods diagnosed CD with a high diagnostic accuracy and reproducibility.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-007-0648-4