Clinical significance of isolated abnormal intestinal findings in magnetic resonance enterography in patients with suspected small bowel disease.

Purpose: Magnetic resonance imaging (MRE) is a well-established adjunct diagnostic tool for the diagnosis of Crohn's Disease (CD), as ileocolonoscopy can sometimes be falsely reassuring when CD skips distal terminal ileum. We aimed to determine the frequency and clinical significance of isolated abn...

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Published in:Abdominal Radiology Vol. 45; no. 4; pp. 1036 - 1044
Main Authors: Alahdab, Yesim Ozen, Demirtas, Coskun Ozer, Kani, Haluk Tarik, Tuney, Davut, Seker, Lamia, Tolu, Tugba, Atug, Ozlen
Format: Journal Article
Published: Springer Nature Apr2020
Online Access:View this record in EBSCOhost
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      dt: Apr2020
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00261-019-02297-5
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        atl: Clinical significance of isolated abnormal intestinal findings in magnetic resonance enterography in patients with suspected small bowel disease.
      aug:
        au:
          Alahdab, Yesim Ozen
          Demirtas, Coskun Ozer
          Kani, Haluk Tarik
          Tuney, Davut
          Seker, Lamia
          Tolu, Tugba
          Atug, Ozlen
        affil: Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
      sug:
      ab: Purpose: Magnetic resonance imaging (MRE) is a well-established adjunct diagnostic tool for the diagnosis of Crohn's Disease (CD), as ileocolonoscopy can sometimes be falsely reassuring when CD skips distal terminal ileum. We aimed to determine the frequency and clinical significance of isolated abnormal small bowel findings in MRE with normal ileal view in ileoscopy. Methods: We retrospectively reviewed findings from 1611 MRE studies that were conducted between 2012 and 2018 to detect patients bearing abnormal intestinal findings and having full ileocolonoscopy. After exclusion of normal or repetitive MRE scans and previously known CD, 147 patients with abnormal MRE detected. MRE scans were categorized as suspicious of CD and non-specific findings. Results: Out of 147 patients with abnormal MRE, 122 (83%) had terminal ileum involvement in MRE consistent with ileoscopy findings. Twenty-five (17%) patients were found to have solitarily abnormal intestinal findings in MRE with normal ileoscopy. Only 3 (12%) were diagnosed with CD initially, and all had MRE findings suspicious of CD. The remainder 40% (n = 10) were diagnosed with non-Crohn's small bowel disease after further investigation, while in the other 48% (n = 12) abnormal MRE findings could not be explained with any organic disease in the follow-up. Conclusion: The present study demonstrated that only a small portion of patients with isolated abnormal intestinal findings in MRE is CD, and more than that are non-crohn's small bowel diseases. These findings, even if they carry the suspicion of CD, do not transform to CD in the long-term follow-up.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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