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 27 May 2018

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News

Enteroclysis vs endoscopy in the diagnosis of lesions in Crohn's

A study in the latest issue of Inflammatory Bowel Diseases correlates magnetic resonance enteroclysis and wireless capsule endoscopy in the diagnosis of small bowel lesions in Crohn's disease.

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Dr Cornelia Tillack and colleagues from Germany evaluated and compared the diagnostic performance of magnetic resonance heterolysis, and wireless video capsule endoscopy in detecting and classifying small bowel Crohn's disease proximal to the terminal ileum.

Magnetic resonance enteroclysis underestimated pathology in 14% of segments
Inflammatory Bowel Diseases

The research team evaluated 19 patients with histologically proven Crohn's disease.

The patients presented with clinical signs suggesting stricturing or inflammatory lesions of Crohn's disease in the proximal small bowel.

All patients underwent magnetic resonance enteroclysis with an infusion technique, and were then admitted to capsule endoscopy.

As for the presence or absence of pathology, results of magnetic resonance enteroclysis and capsule endoscopy were in total agreement for 85% of evaluated segments.

In judging lesion severity, magnetic resonance enteroclysis and capsule endoscopy yielded identical results in 56% of segments.

The team noted that magnetic resonance enteroclysis underestimated pathology in 14% of segments, and revealed more severe pathology in 12% of segments.

The researchers found that capsule endoscopy identified subtle or severe mucosal pathology, while magnetic resonance enteroclysis was normal.

Capsule endoscopy entirely missed severe inflammatory mural changes depicted in magnetic resonance enteroclysis in 2% of segments.

Dr Tillack's team concluded, "Magnetic resonance enteroclysis and capsule endoscopy show good correlation in the detection and localization of inflammatory bowel disease."

"As for disease activity, magnetic resonance enteroclysis is inferior in the detection of superficial mucosal disease."

"However, magnetic resonance heterolysis reliably discloses the presence of severe inflammatory changes within the bowel wall and beyond, which may be underestimated from the endoscopic aspect of the mucosal surface."

"Magnetic resonance enteroclysis helps to rule out severe stenoses that should be referred for immediate surgical intervention."

"Both modalities are complementary."

"We recommend that magnetic resonance enteroclysis be used in more severe cases of Crohn's disease, and in patients who might have involvement beyond the mucosa of the small bowel."

Inflamm Bowel Dis 2008: 14(9): 1219-28
13 August 2008

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