Satheesh Krishna1,2, Naveen Kalra1, Paramjeet Singh1, Rakesh Kochhar3, Rajesh Gupta4, Rajinder Singh4, Niranjan Khandelwal1. 1. 1 Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. 2. 2 Present address: Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada. 3. 3 Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 4. 4 Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
OBJECTIVE: The purpose of this article is to describe the MR enterographic findings of small-bowel tuberculosis (TB) and to compare the imaging findings of small-bowel follow-through (SBFT) with those of MR enterography. SUBJECTS AND METHODS: Thirty patients (20 male and 10 female) presenting with suspected intestinal TB were enrolled in this prospective study. MR enterography and SBFT were performed within 2 weeks of each other. RESULTS: Nineteen of the 30 patients were confirmed to have TB. Of these 19 patients, MR enterography depicted ileocecal involvement in nine patients (47%), mural thickening in any other segment of the small bowel in 11 patients (58%), lymphadenopathy in 17 patients (89%), ascites in five patients (26%), and peritoneal enhancement in six patients (32%). In addition, MRI also depicted a splenic granuloma, spondylodiscitis with prevertebral abscess, and small-bowel perforation with collections in one patient each. There was good correlation between MR enterography and SBFT in the depiction of ileocecal involvement and small-bowel mural thickening. However, MR enterography was able to show a higher number of strictures than was SBFT. The sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of TB were 100%, 73%, 86%, and 100%, respectively, for MR enterography and 88%, 70%, 83%, and 78%, respectively, for SBFT. The difference was not statistically significant (p = 0.24). CONCLUSION: MR enterography depicts intestinal as well as extraintestinal manifestations of TB. The intestinal manifestations correlate well with SBFT findings. MR enterography has the potential to become the one-stop radiation-free tool in the evaluation of small-bowel TB.
OBJECTIVE: The purpose of this article is to describe the MR enterographic findings of small-bowel tuberculosis (TB) and to compare the imaging findings of small-bowel follow-through (SBFT) with those of MR enterography. SUBJECTS AND METHODS: Thirty patients (20 male and 10 female) presenting with suspected intestinal TB were enrolled in this prospective study. MR enterography and SBFT were performed within 2 weeks of each other. RESULTS: Nineteen of the 30 patients were confirmed to have TB. Of these 19 patients, MR enterography depicted ileocecal involvement in nine patients (47%), mural thickening in any other segment of the small bowel in 11 patients (58%), lymphadenopathy in 17 patients (89%), ascites in five patients (26%), and peritoneal enhancement in six patients (32%). In addition, MRI also depicted a splenic granuloma, spondylodiscitis with prevertebral abscess, and small-bowel perforation with collections in one patient each. There was good correlation between MR enterography and SBFT in the depiction of ileocecal involvement and small-bowel mural thickening. However, MR enterography was able to show a higher number of strictures than was SBFT. The sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of TB were 100%, 73%, 86%, and 100%, respectively, for MR enterography and 88%, 70%, 83%, and 78%, respectively, for SBFT. The difference was not statistically significant (p = 0.24). CONCLUSION: MR enterography depicts intestinal as well as extraintestinal manifestations of TB. The intestinal manifestations correlate well with SBFT findings. MR enterography has the potential to become the one-stop radiation-free tool in the evaluation of small-bowel TB.
Entities:
Keywords:
MRI; fluoroscopy; gastrointestinal tuberculosis; small intestine; tuberculosis
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