Diagnostic accuracy of non-contrast magnetic resonance enterography in detecting active bowel inflammation in pediatric patients with diagnosed or suspected inflammatory bowel disease to determine necessity of gadolinium-based contrast agents.
Background: Pediatric patients with inflammatory bowel disease (IBD) are at increased risk of gadolinium deposition given the potential need for multiple contrast-enhanced magnetic resonance enterography (MRE) exams over their lifetime.Objective: To determine whether gadolinium-based contrast agents...
| Publicado en: | Pediatric Radiology Vol. 49; no. 6; pp. 759 - 770 |
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| Autores principales: | , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
May2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136338318&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136338318 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03010449 O03 jtl: Pediatric Radiology issn: 03010449 maglogo: N pubinfo: dt: May2019 vid: 49 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 136338318 136338318 NLM30899973 136338318 10.1007/s00247-019-04369-6 NLM30899973 136338318 ppf: 759 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Diagnostic accuracy of non-contrast magnetic resonance enterography in detecting active bowel inflammation in pediatric patients with diagnosed or suspected inflammatory bowel disease to determine necessity of gadolinium-based contrast agents. aug: au: Kim, Stacy J. Ratchford, Thomas L. Buchanan, Paula M. Patel, Dhiren R. Tao, Ting Y. Teckman, Jeffrey H. Brown, Jeffrey J. Farmakis, Shannon G. affil: Department of Radiology, SSM Saint Louis University Hospital, Saint Louis University School of Medicine, 3635 Vista Ave. at Grand Boulevard, 63110, St. Louis, MO, USA sug: subj: Inflammatory Bowel Diseases Magnetic Resonance Imaging Methods Sorbitol Contrast Media Male Endoscopy, Gastrointestinal Female Adolescence Child Sensitivity and Specificity Retrospective Design Organometallic Compounds Human Adolescent: 13-18 years Child: 6-12 years Male Female ab: Background: Pediatric patients with inflammatory bowel disease (IBD) are at increased risk of gadolinium deposition given the potential need for multiple contrast-enhanced magnetic resonance enterography (MRE) exams over their lifetime.Objective: To determine whether gadolinium-based contrast agents are necessary in assessing active bowel inflammation on MRE in pediatric patients with known or suspected IBD.Materials and Methods: We conducted a retrospective study of 77 patients (7-18 years; 68.8% male) with known (n=58) or suspected (n=19) IBD and endoscopy with biopsy performed within 30 days of MRE without and with contrast evaluated bowel and non-bowel findings. During three visual analysis sessions, two radiologists reviewed pre-, post-, and pre-/post-contrast MRE images. A third radiologist independently reviewed 27 studies to assess inter-reader reliability. We used Cohen kappa (κ), Fleiss kappa, (κF), McNemar test, and sensitivity and specificity to compare MRE readings to combined endoscopic/histopathological findings (the reference standard).Results: The pre- and pre-/post-contrast-enhanced MRE vs. combined endoscopic/histopathological results had moderate agreement (85.7%; κ 0.713, P<0.001; P-value 0.549). Compared to combined endoscopy/histopathology, pre- vs. pre-/post-contrast sensitivity (67%, confidence interval [CI] 0.53-0.79 vs. 67%, CI 0.53-0.79) and specificity (80%, CI 0.59-0.92 vs. 68%, CI 0.46-0.84) varied little (κ 0.42, P<0.001 and κ 0.32, P=0.003, respectively). The three readers had moderate agreement (85.2%; κ 0.695, P=0.001; P-value 0.625). More penetrating complications were identified following contrast administration (P-value 0.04).Conclusion: Use of a contrast agent does not improve the detection of active inflammation in the terminal ileum and colon compared to non-contrast MRE, although use of a contrast agent does aid in the detection of penetrating disease. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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