AIM: To assess the impact of magnetic resonance enterography (MRE) on clinician diagnostic confidence and therapeutic strategy in patients under investigation for small bowel Crohn's disease. MATERIAL AND METHODS: Gastroenterologists completed a proforma before and following MRE in 51 patients (mean age 35 years, 26 female) under investigation for small bowel Crohn's disease, indicating percentage confidence for presence/absence of small bowel involvement. In suspected disease, diagnostic confidence (using a scoring system from 1=no to 6=yes) was scored for subcategories: extent >30 cm (DE), terminal ileum (lTI), jejunal (JD), colonic disease (CoD), strictures (ST), activity (AD), extraluminal complications (EL), and surgical need (NS). Therapeutic strategy was recorded. Patients were divided into three groups: 1=suspected disease, MRE normal (n=15); 2=suspected disease, MRE abnormal (n=30); 3=no suspected disease, MRE normal (n=6). Binomial exact and paired t-tests were use to compare confidence pre and post-MRE. RESULTS: Mean percentage confidence for the presence/absence of small bowel disease increased from 62 to 84% (p=0.003), 87 to 98% (p=0.0001), and 83 to 98% (p=0.005) after MRE for groups 1, 2, and 3, respectively. In suspected disease, confidence changed significantly for all of the subcategories (p<0.001) except EL in group 1. The percentage of patients with a confidence change ranged from 40% (CoD) to 87% (lTI; group 1) and from 7% (EL) to 93% (DE; group 2). Therapeutic strategy changed in 31/51 (61%, 95% CI 47-74%), 14 with a reduction in planned therapy and 17 with an increase. CONCLUSION: MRE had a positive diagnostic impact in patients under investigation for small bowel Crohn's disease and this influenced therapeutic strategy in 61% of the patients. 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
AIM: To assess the impact of magnetic resonance enterography (MRE) on clinician diagnostic confidence and therapeutic strategy in patients under investigation for small bowel Crohn's disease. MATERIAL AND METHODS: Gastroenterologists completed a proforma before and following MRE in 51 patients (mean age 35 years, 26 female) under investigation for small bowel Crohn's disease, indicating percentage confidence for presence/absence of small bowel involvement. In suspected disease, diagnostic confidence (using a scoring system from 1=no to 6=yes) was scored for subcategories: extent >30 cm (DE), terminal ileum (lTI), jejunal (JD), colonic disease (CoD), strictures (ST), activity (AD), extraluminal complications (EL), and surgical need (NS). Therapeutic strategy was recorded. Patients were divided into three groups: 1=suspected disease, MRE normal (n=15); 2=suspected disease, MRE abnormal (n=30); 3=no suspected disease, MRE normal (n=6). Binomial exact and paired t-tests were use to compare confidence pre and post-MRE. RESULTS: Mean percentage confidence for the presence/absence of small bowel disease increased from 62 to 84% (p=0.003), 87 to 98% (p=0.0001), and 83 to 98% (p=0.005) after MRE for groups 1, 2, and 3, respectively. In suspected disease, confidence changed significantly for all of the subcategories (p<0.001) except EL in group 1. The percentage of patients with a confidence change ranged from 40% (CoD) to 87% (lTI; group 1) and from 7% (EL) to 93% (DE; group 2). Therapeutic strategy changed in 31/51 (61%, 95% CI 47-74%), 14 with a reduction in planned therapy and 17 with an increase. CONCLUSION: MRE had a positive diagnostic impact in patients under investigation for small bowel Crohn's disease and this influenced therapeutic strategy in 61% of the patients. 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Authors: Michael R Torkzad; Gabriele Masselli; Steve Halligan; Aytek Oto; Henning Neubauer; Stuart Taylor; Arun Gupta; Jens Brøndum Frøkjær; Ian C Lawrance; Christopher J Welman; Anne Negård; Olle Ekberg; Michael Patak; Thomas Lauenstein Journal: Insights Imaging Date: 2015-04-09
Authors: Stuart Taylor; Susan Mallett; Gauraang Bhatnagar; Stuart Bloom; Arun Gupta; Steve Halligan; John Hamlin; Ailsa Hart; Antony Higginson; Ilan Jacobs; Sara McCartney; Steve Morris; Nicola Muirhead; Charles Murray; Shonit Punwani; Manuel Rodriguez-Justo; Andrew Slater; Simon Travis; Damian Tolan; Alastair Windsor; Peter Wylie; Ian Zealley Journal: BMC Gastroenterol Date: 2014-08-11 Impact factor: 3.067
Authors: Anjali S Kumar; Jasna Coralic; Reid Vegeler; Kirthi Kolli; John Liang; Allison Estep; Allen P Chudzinski; James D McFadden Journal: Case Rep Gastrointest Med Date: 2015-01-26