OBJECTIVES: To determine the usefulness of MR enterography in the detection of recurrence in the ileocolonic anastomosis in patients with Crohn's disease that have undergone intestinal resection. MATERIAL AND METHODS: We used MR enterography and ileocolonoscopy to study 30 patients with Crohn's disease who had undergone intestinal resection. To determine the degree of relapse, the findings at MR enterography were quantified using our own index of Crohn's disease activity and the findings at ileocolonoscopy were quantified using the Rutgeerts scale. Ileocolonoscopy was considered the gold standard. RESULTS: Compared to the gold standard, MR enterography yielded 100% sensitivity, 60% specificity, 92.6% positive predictive value (PPV), 100% negative predictive value (NPV), and 93.3% diagnostic accuracy. The concordance between the degree of recurrence determined with MR enterography and with ileocolonoscopy was moderate (κ=0.41). However, when patients were classified into two groups (high or low grade) according to outcome and the possibility of repeat surgery, the concordance was excellent (κ=0.87). Using this classification, MR enterography had 85% sensitivity, 100% specificity, 100% PPV, and 76.9% NPV. CONCLUSIONS: MR enterography is a useful imaging method for detecting recurrence of Crohn's disease after surgery and for differentiating between patients with higher or lower risk of poor outcome. MR enterography has good concordance with ileocolonoscopy and is an alternative to ileocolonoscopy in determinate occasions.
OBJECTIVES: To determine the usefulness of MR enterography in the detection of recurrence in the ileocolonic anastomosis in patients with Crohn's disease that have undergone intestinal resection. MATERIAL AND METHODS: We used MR enterography and ileocolonoscopy to study 30 patients with Crohn's disease who had undergone intestinal resection. To determine the degree of relapse, the findings at MR enterography were quantified using our own index of Crohn's disease activity and the findings at ileocolonoscopy were quantified using the Rutgeerts scale. Ileocolonoscopy was considered the gold standard. RESULTS: Compared to the gold standard, MR enterography yielded 100% sensitivity, 60% specificity, 92.6% positive predictive value (PPV), 100% negative predictive value (NPV), and 93.3% diagnostic accuracy. The concordance between the degree of recurrence determined with MR enterography and with ileocolonoscopy was moderate (κ=0.41). However, when patients were classified into two groups (high or low grade) according to outcome and the possibility of repeat surgery, the concordance was excellent (κ=0.87). Using this classification, MR enterography had 85% sensitivity, 100% specificity, 100% PPV, and 76.9% NPV. CONCLUSIONS: MR enterography is a useful imaging method for detecting recurrence of Crohn's disease after surgery and for differentiating between patients with higher or lower risk of poor outcome. MR enterography has good concordance with ileocolonoscopy and is an alternative to ileocolonoscopy in determinate occasions.
Authors: Saurabh Kedia; Raju Sharma; Govind K Makharia; Vineet Ahuja; Devendra Desai; Devasenathipathy Kandasamy; Anu Eapen; Karthik Ganesan; Uday C Ghoshal; Naveen Kalra; D Karthikeyan; Kumble Seetharama Madhusudhan; Mathew Philip; Amarender Singh Puri; Sunil Puri; Saroj K Sinha; Rupa Banerjee; Shobna Bhatia; Naresh Bhat; Sunil Dadhich; G K Dhali; B D Goswami; S K Issar; V Jayanthi; S P Misra; Sandeep Nijhawan; Pankaj Puri; Avik Sarkar; S P Singh; Anshu Srivastava; Philip Abraham; B S Ramakrishna Journal: Indian J Gastroenterol Date: 2018-01-06
Authors: María Jesús Martínez; Tomás Ripollés; Jose María Paredes; Eduardo Moreno-Osset; Juan Manuel Pazos; Esther Blanc Journal: Dig Dis Sci Date: 2019-01-02 Impact factor: 3.199
Authors: Piotr Eder; Michal Michalak; Katarzyna Katulska; Liliana Lykowska-Szuber; Iwona Krela-Kazmierczak; Kamila Stawczyk-Eder; Katarzyna Klimczak; Aleksandra Szymczak; Krzysztof Linke Journal: Sci Rep Date: 2015-05-20 Impact factor: 4.379
Authors: In Young Choi; Sang Hyoung Park; Seong Ho Park; Chang Sik Yu; Yong Sik Yoon; Jong Lyul Lee; Byong Duk Ye; Ah Young Kim; Suk-Kyun Yang Journal: Korean J Radiol Date: 2017-09-21 Impact factor: 3.500