Skip to main content
Top
Published in: European Radiology 4/2011

01-04-2011 | Magnetic Resonance

MR enterography versus capsule endoscopy in paediatric patients with suspected Crohn’s disease

Authors: Emanuele Casciani, Gabriele Masselli, Giovanni Di Nardo, Elisabetta Polettini, Luca Bertini, Salvatore Oliva, Irene Floriani, Salvatore Cucchiara, Gianfranco Gualdi

Published in: European Radiology | Issue 4/2011

Login to get access

Abstract

Objective

The aim of this prospective study was to compare the diagnostic yield of MR enterography (MRE) with small-bowel capsule endoscopy (SBCE) in paediatric patients with suspected Crohn’s disease (CD).

Methods

Paediatric patients with suspected CD were considered eligible to be enrolled in the study. All patients underwent diagnostic work-up including 1.5-T MRE, ileo-colonoscopy and oesophagogastroduodenoscopy. SBCE was not performed if MRE showed SB stricture or extra-intestinal findings consistent with symptoms.

Results

Sixty consecutive paediatric patients (36 male; average age 14) were enrolled into the study. A positive diagnosis for CD was made in 19 patients, 29 had a negative result and 12 were affected by other gastro-intestinal conditions. SBCE was performed in 37 patients (61.7%); 23 patients were excluded (strictures in five, extra-intestinal findings in 11 and parents’ refusal in seven cases). The accuracy, sensitivity, and specificity of MRE and SBCE were 98.3%, 100%, 97.6%, and 91.9%, 90.9%, 92.3%, respectively.

Conclusion

Both MRE and SBCE are accurate methods for patients with suspected CD. MRE can be used as a primary imaging technique in suspected CD, in that it allows access to the ileal stricture, which forms a contra-indication for SBCE and provides extra-intestinal information.
Literature
1.
go back to reference Weiss B, Shamir R, Bujanover Y (2004) NOD2/CARD15 mutation analysis and genotype-phenotype correlation in Jewish pediatric patients compared with adults with Crohn’s disease. J Pediatr 145:208–212PubMedCrossRef Weiss B, Shamir R, Bujanover Y (2004) NOD2/CARD15 mutation analysis and genotype-phenotype correlation in Jewish pediatric patients compared with adults with Crohn’s disease. J Pediatr 145:208–212PubMedCrossRef
2.
go back to reference Kurugoglu S, Korman U, Adaletli I, Selcuk D (2007) Enteroclysis in older children and teenagers. Pediatr Radiol 37:457–466PubMedCrossRef Kurugoglu S, Korman U, Adaletli I, Selcuk D (2007) Enteroclysis in older children and teenagers. Pediatr Radiol 37:457–466PubMedCrossRef
3.
go back to reference Lipson A, Bartram CI, Williams CB (1990) Barium studies and ileoscopy compared in children with suspected Crohn’s disease. Clin Radiol 41:5–8PubMedCrossRef Lipson A, Bartram CI, Williams CB (1990) Barium studies and ileoscopy compared in children with suspected Crohn’s disease. Clin Radiol 41:5–8PubMedCrossRef
4.
go back to reference Halligan S, Nicholls S, Beattie RM (1995) The role of small bowel radiology in the diagnosis and management of Crohn’s disease. Acta Paediatr 84:1375–1378PubMedCrossRef Halligan S, Nicholls S, Beattie RM (1995) The role of small bowel radiology in the diagnosis and management of Crohn’s disease. Acta Paediatr 84:1375–1378PubMedCrossRef
5.
go back to reference Batres LA, Maller ES, Ruchelli E (2002) Terminal ileum intubation in pediatric colonoscopy and diagnostic value of conventional small bowel contrast radiography in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 35:320–323PubMedCrossRef Batres LA, Maller ES, Ruchelli E (2002) Terminal ileum intubation in pediatric colonoscopy and diagnostic value of conventional small bowel contrast radiography in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 35:320–323PubMedCrossRef
6.
go back to reference Gaca AM, Jaffe TA, Delaney S (2008) Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease. Pediatr Radiol 38:285–291PubMedCrossRef Gaca AM, Jaffe TA, Delaney S (2008) Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease. Pediatr Radiol 38:285–291PubMedCrossRef
7.
go back to reference Paulsen SR, Huprich JE, Fletcher JG (2006) CT enterography as a diagnostic tool in evaluating small bowel disorders: review of clinical experience with over 700 cases. Radiographics 26:641–657PubMedCrossRef Paulsen SR, Huprich JE, Fletcher JG (2006) CT enterography as a diagnostic tool in evaluating small bowel disorders: review of clinical experience with over 700 cases. Radiographics 26:641–657PubMedCrossRef
8.
go back to reference Jaffe TA, Gaca AM, Delaney S (2007) Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohn’s disease. AJR Am J Roentgenol 189:1015–1022PubMedCrossRef Jaffe TA, Gaca AM, Delaney S (2007) Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohn’s disease. AJR Am J Roentgenol 189:1015–1022PubMedCrossRef
9.
go back to reference Siddiki HA, Fidler JL, Fletcher JG (2009) Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn’s disease. AJR Am J Roentgenol 193:113–121PubMedCrossRef Siddiki HA, Fidler JL, Fletcher JG (2009) Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn’s disease. AJR Am J Roentgenol 193:113–121PubMedCrossRef
10.
go back to reference Lee SS, Kim AY, Yang SK (2009) Crohn disease of the small bowel: comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. Radiology 251:751–761PubMedCrossRef Lee SS, Kim AY, Yang SK (2009) Crohn disease of the small bowel: comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. Radiology 251:751–761PubMedCrossRef
11.
go back to reference Rey JF, Ladas S, Alhassani A, Kuznetsov K, ESGE Guidelines Committee (2006) European Society of Gastrointestinal Endoscopy (ESGE). Video capsule endoscopy: update to guidelines. Endoscopy 38:1047–1053PubMedCrossRef Rey JF, Ladas S, Alhassani A, Kuznetsov K, ESGE Guidelines Committee (2006) European Society of Gastrointestinal Endoscopy (ESGE). Video capsule endoscopy: update to guidelines. Endoscopy 38:1047–1053PubMedCrossRef
12.
go back to reference Ladas SD, Triantafyllou K, Spada C, Riccioni ME, Rey JF, Niv Y, Delvaux M, de Franchis R, Costamagna G, ESGE Clinical Guidelines Committee (2010) European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases. Endoscopy 42:220–227PubMedCrossRef Ladas SD, Triantafyllou K, Spada C, Riccioni ME, Rey JF, Niv Y, Delvaux M, de Franchis R, Costamagna G, ESGE Clinical Guidelines Committee (2010) European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases. Endoscopy 42:220–227PubMedCrossRef
13.
go back to reference Van Assche G, Dignass A, Panes J, Beaugerie L et al (2010) The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. J Crohn’s and Colitis 4:7–27CrossRef Van Assche G, Dignass A, Panes J, Beaugerie L et al (2010) The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. J Crohn’s and Colitis 4:7–27CrossRef
14.
go back to reference Leyendecker JR, Bloomfeld RS, DiSantis DJ, Water GS, Mott R, Bechtold RE (2009) MR enterography in the management of Patients with Crohn disease. RadioGraphics 29:1827–1846PubMedCrossRef Leyendecker JR, Bloomfeld RS, DiSantis DJ, Water GS, Mott R, Bechtold RE (2009) MR enterography in the management of Patients with Crohn disease. RadioGraphics 29:1827–1846PubMedCrossRef
16.
go back to reference Shamir R, Eliakim R (2008) Capsule endoscopy in pediatric patients. World J Gastroenterol 14:4152–4155PubMedCrossRef Shamir R, Eliakim R (2008) Capsule endoscopy in pediatric patients. World J Gastroenterol 14:4152–4155PubMedCrossRef
17.
go back to reference Mow WS, Lo SK, Targan SR (2004) Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease. Clin Gastroenterol Hepatol 2:31–40PubMedCrossRef Mow WS, Lo SK, Targan SR (2004) Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease. Clin Gastroenterol Hepatol 2:31–40PubMedCrossRef
18.
go back to reference Schreyer AG, Geissler A, Albrich H (2004) Abdominal MRI after enteroclysis or with oral contrast in patients with suspected or proven Crohn’s disease. Clin Gastroenterol Hepatol 2:491–497PubMedCrossRef Schreyer AG, Geissler A, Albrich H (2004) Abdominal MRI after enteroclysis or with oral contrast in patients with suspected or proven Crohn’s disease. Clin Gastroenterol Hepatol 2:491–497PubMedCrossRef
19.
go back to reference Masselli G, Casciani E, Polettini E (2006) Assessment of Crohn’s disease in the small bowel: prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis. Eur Radiol 16:2817–2827PubMedCrossRef Masselli G, Casciani E, Polettini E (2006) Assessment of Crohns disease in the small bowel: prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis. Eur Radiol 16:2817–2827PubMedCrossRef
20.
go back to reference Negaard A, Paulsen V, Sandvik L (2007) A prospective randomized comparison between two MRI studies of the small bowel in Crohn’s disease, the oral contrast method and MR enteroclysis. Eur Radiol 17:2294–2301PubMedCrossRef Negaard A, Paulsen V, Sandvik L (2007) A prospective randomized comparison between two MRI studies of the small bowel in Crohn’s disease, the oral contrast method and MR enteroclysis. Eur Radiol 17:2294–2301PubMedCrossRef
21.
go back to reference Masselli G, Casciani E, Polettini E (2008) Comparison of MR enteroclysis with MR enterography and conventional enteroclysis in patients with Crohn’s disease. Eur Radiol 18:438–447PubMedCrossRef Masselli G, Casciani E, Polettini E (2008) Comparison of MR enteroclysis with MR enterography and conventional enteroclysis in patients with Crohns disease. Eur Radiol 18:438–447PubMedCrossRef
22.
go back to reference Golder SK, Schreyer AG, Endlicher E (2006) Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease. Int J Colorectal Dis 21:97–104PubMedCrossRef Golder SK, Schreyer AG, Endlicher E (2006) Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease. Int J Colorectal Dis 21:97–104PubMedCrossRef
23.
go back to reference Albert JG, Martiny F, Krummenerl A (2005) Diagnosis of small bowel Crohn’s disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut 54:1721–1727PubMedCrossRef Albert JG, Martiny F, Krummenerl A (2005) Diagnosis of small bowel Crohn’s disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut 54:1721–1727PubMedCrossRef
24.
go back to reference Horsthuis K, Bipat S, Stokkers PCF, Stoker J (2009) Magnetic resonance imaging for evaluation of disease activity in Crohn’s disease: a systematic review. Eur Radiol 19:1450–1460PubMedCrossRef Horsthuis K, Bipat S, Stokkers PCF, Stoker J (2009) Magnetic resonance imaging for evaluation of disease activity in Crohns disease: a systematic review. Eur Radiol 19:1450–1460PubMedCrossRef
25.
go back to reference Goldstein JL, Eisen GM, Lewis B (2005) Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo. Clin Gastroenterol Hepatol 3:133–141PubMedCrossRef Goldstein JL, Eisen GM, Lewis B (2005) Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo. Clin Gastroenterol Hepatol 3:133–141PubMedCrossRef
26.
go back to reference Jensen MD, Nathan T, Kjeldsen J (2010) Incidental findings at MRI-enterography in patients with suspected or known Crohn’s disease. World J Gastroenterol 16(1):76–82PubMed Jensen MD, Nathan T, Kjeldsen J (2010) Incidental findings at MRI-enterography in patients with suspected or known Crohn’s disease. World J Gastroenterol 16(1):76–82PubMed
Metadata
Title
MR enterography versus capsule endoscopy in paediatric patients with suspected Crohn’s disease
Authors
Emanuele Casciani
Gabriele Masselli
Giovanni Di Nardo
Elisabetta Polettini
Luca Bertini
Salvatore Oliva
Irene Floriani
Salvatore Cucchiara
Gianfranco Gualdi
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 4/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1976-3

Other articles of this Issue 4/2011

European Radiology 4/2011 Go to the issue