Alessandro Campari1,2, Marcello Napolitano3, Giovanna Zuin4, Luciano Maestri5, Giovanni Di Leo6, Francesco Sardanelli6,7. 1. Radiology Department, E. Bassini Hospital - ASST Nord Milano, via Gorki, 50, 20092, Cinisello Balsamo, Milan, Italy. alessandro.campari@unimi.it. 2. Pediatric Radiology Department, V. Buzzi Children's Hospital - ASST Fatebenefratelli-Sacco, via Castelvetro 32, 20154, Milan, Italy. alessandro.campari@unimi.it. 3. Pediatric Radiology Department, V. Buzzi Children's Hospital - ASST Fatebenefratelli-Sacco, via Castelvetro 32, 20154, Milan, Italy. 4. Pediatric Department, V. Buzzi Children's Hospital - ASST Fatebenefratelli-Sacco, via Castelvetro 32, 20154, Milan, Italy. 5. Pediatric Surgery Department, V. Buzzi Children's Hospital - ASST Fatebenefratelli-Sacco, via Castelvetro 32, 20154, Milan, Italy. 6. Radiology Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy. 7. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy.
Abstract
BACKGROUND: Colonic involvement in pediatric inflammatory bowel disease is common. Magnetic resonance (MR) enterography is considered the best imaging modality for pediatric inflammatory bowel disease evaluation. It is unclear whether the lack of a dedicated large bowel preparation prevents a reliable colonic assessment. OBJECTIVE: To determine the diagnostic performance of standard MR enterography in detecting and grading colonic inflammatory activity. MATERIALS AND METHODS: We retrospectively evaluated children who underwent both MR enterography and ileocolonoscopy with biopsies <4 weeks apart. Two radiologists independently reviewed MR examinations and quantified inflammation in each of the five colonic segments using a standardized MR score system. Findings were compared with histological examination of the corresponding segment. Mann-Whitney, Kruskal-Wallis, Jonckheere-Terpstra and Bland-Altman statistics were used. RESULTS: One hundred seventy-five segments from 37 examinations were included. MR enterography diagnostic performance for inflammation was as follows: sensitivity 94% (95% confidence interval [CI]: 90-97%), specificity: 64% (95% CI: 57-71%). A significant positive correlation was found between MR score and inflammatory activity histologically graded (P<0.001, Jonckheere-Terpstra test). The interobserver agreement was good (mean difference between MR enterography scores was -0.03; limits of agreement -2.8 to 2.7). CONCLUSION: Standard MR enterography is sensitive for the detection of actively inflamed colonic segments. MR enterography might provide useful information for guiding biopsies and its role as an alternative to ileocolonoscopy in monitoring colonic disease activity in children should be further investigated.
BACKGROUND:Colonic involvement in pediatric inflammatory bowel disease is common. Magnetic resonance (MR) enterography is considered the best imaging modality for pediatric inflammatory bowel disease evaluation. It is unclear whether the lack of a dedicated large bowel preparation prevents a reliable colonic assessment. OBJECTIVE: To determine the diagnostic performance of standard MR enterography in detecting and grading colonic inflammatory activity. MATERIALS AND METHODS: We retrospectively evaluated children who underwent both MR enterography and ileocolonoscopy with biopsies <4 weeks apart. Two radiologists independently reviewed MR examinations and quantified inflammation in each of the five colonic segments using a standardized MR score system. Findings were compared with histological examination of the corresponding segment. Mann-Whitney, Kruskal-Wallis, Jonckheere-Terpstra and Bland-Altman statistics were used. RESULTS: One hundred seventy-five segments from 37 examinations were included. MR enterography diagnostic performance for inflammation was as follows: sensitivity 94% (95% confidence interval [CI]: 90-97%), specificity: 64% (95% CI: 57-71%). A significant positive correlation was found between MR score and inflammatory activity histologically graded (P<0.001, Jonckheere-Terpstra test). The interobserver agreement was good (mean difference between MR enterography scores was -0.03; limits of agreement -2.8 to 2.7). CONCLUSION: Standard MR enterography is sensitive for the detection of actively inflamed colonic segments. MR enterography might provide useful information for guiding biopsies and its role as an alternative to ileocolonoscopy in monitoring colonic disease activity in children should be further investigated.
Authors: Jesica C Makanyanga; Doug Pendsé; Nikolaos Dikaios; Stuart Bloom; Sara McCartney; Emma Helbren; Elaine Atkins; Terry Cuthbertson; Shonit Punwani; Alastair Forbes; Steve Halligan; Stuart A Taylor Journal: Eur Radiol Date: 2013-09-12 Impact factor: 5.315
Authors: Michael J Steward; Shonit Punwani; Ian Proctor; Yvette Adjei-Gyamfi; Fiona Chatterjee; Stuart Bloom; Marco Novelli; Steve Halligan; Manuel Rodriguez-Justo; Stuart A Taylor Journal: Eur J Radiol Date: 2011-09-15 Impact factor: 3.528
Authors: Giuseppe Cicero; Stefania Mondello; Julian L Wichmann; Moritz H Albrecht; Thomas J Vogl; Marco Cavallaro; Luciano Frosina; Tommaso D'Angelo; Silvio Mazziotti Journal: J Clin Imaging Sci Date: 2020-05-02