Mohammadreza Chavoshi1, Seyed Ali Mirshahvalad2, Amir Kasaeian3, Shirin Djalalinia4, Shadi Kolahdoozan5, Amir Reza Radmard6. 1. Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2. Department of Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 3. Hematology, Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology, and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran; Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 4. Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran; Non-communicable Diseases Research Center, EMRI, Tehran University of Medical Sciences, Tehran, Iran. 5. Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 6. Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: amir.radmard@gmail.com.
Abstract
OBJECTIVES: To Evaluate the diagnostic performance of magnetic resonance enterography (MRE) for detecting colonic involvement of Crohn's disease (CD). MATERIALS AND METHODS: A systematic search of the electronic bibliographic databases was conducted. The inclusion criteria of published original articles were: (1) Utilized MRE to evaluate colon; (2) Patients with documented CD by colonoscopy; (3) Provided crude data of diagnostic performance in the large bowel; (4) Performed segmental evaluation. The colorectal segments were defined as the right colon, transverse colon, left colon, and rectum. A hierarchical bivariate method was used for analysis. RESULTS: Eleven articles (12 populations and 987 patients) were included. The pooled sensitivity and specificity of the studies were 69% (95% CI: 0.52-0.82) and 95% (95% CI:0.92-0.97), respectively (AUC = 0.95). The pooled positive and negative likelihood ratios were 14 (95% CI:7.5-26.3) and 0.31 (95% CI:0.19-0.51), respectively. Regarding segments, the left colon had the highest sensitivity (60%) and lowest specificity (92%), while the transverse colon showed lowest sensitivity (49%) and highest specificity (95%). Comparing the age groups, MRE sensitivity and specificity was 80% and 95%, versus 62% and 94%, in pediatrics and adults respectively. CONCLUSION: MRE has a high specificity to detect colon pathologies in CD, while the sensitivity is low. Therefore, the test has a high value to rule in CD, while negative results are not sufficient to rule it out. Meanwhile, considering the higher sensitivity rate of the test in pediatrics, it has the potential to be used as a first-line investigation.
OBJECTIVES: To Evaluate the diagnostic performance of magnetic resonance enterography (MRE) for detecting colonic involvement of Crohn's disease (CD). MATERIALS AND METHODS: A systematic search of the electronic bibliographic databases was conducted. The inclusion criteria of published original articles were: (1) Utilized MRE to evaluate colon; (2) Patients with documented CD by colonoscopy; (3) Provided crude data of diagnostic performance in the large bowel; (4) Performed segmental evaluation. The colorectal segments were defined as the right colon, transverse colon, left colon, and rectum. A hierarchical bivariate method was used for analysis. RESULTS: Eleven articles (12 populations and 987 patients) were included. The pooled sensitivity and specificity of the studies were 69% (95% CI: 0.52-0.82) and 95% (95% CI:0.92-0.97), respectively (AUC = 0.95). The pooled positive and negative likelihood ratios were 14 (95% CI:7.5-26.3) and 0.31 (95% CI:0.19-0.51), respectively. Regarding segments, the left colon had the highest sensitivity (60%) and lowest specificity (92%), while the transverse colon showed lowest sensitivity (49%) and highest specificity (95%). Comparing the age groups, MRE sensitivity and specificity was 80% and 95%, versus 62% and 94%, in pediatrics and adults respectively. CONCLUSION: MRE has a high specificity to detect colon pathologies in CD, while the sensitivity is low. Therefore, the test has a high value to rule in CD, while negative results are not sufficient to rule it out. Meanwhile, considering the higher sensitivity rate of the test in pediatrics, it has the potential to be used as a first-line investigation.