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Published on: August 26, 2014
MR enterography versus capsule endoscopy in paediatric patients with suspected Crohn's disease
Emanuele Casciani1, Gabriele Masselli, Giovanni Di Nardo
1Radiology DEA, Azienda Policlinico Umberto I, La Sapienza University, Via del Policlinico, 155, 00166 Rome, Italy. emanuelecasciani@gmail.com
Insights
MR enterography (MRE) and small-bowel capsule endoscopy (SBCE) accurately diagnose Crohn's disease (CD) in children. MRE is recommended as a first-line imaging tool due to its ability to identify contraindications for SBCE.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Inflammatory Bowel Disease
Background:
- Crohn's disease (CD) diagnosis in pediatric patients can be challenging.
- Accurate diagnostic tools are crucial for timely and effective management of pediatric CD.
Purpose of the Study:
- To compare the diagnostic yield of MR enterography (MRE) and small-bowel capsule endoscopy (SBCE).
- To evaluate the efficacy of MRE and SBCE in pediatric patients with suspected Crohn's disease.
Main Methods:
- Prospective study comparing MRE and SBCE in pediatric patients with suspected CD.
- Patients underwent MRE, ileo-colonoscopy, and oesophagogastroduodenoscopy.
- SBCE was performed selectively, avoiding cases with MRE-identified strictures or extra-intestinal findings.
Main Results:
- Sixty pediatric patients were enrolled; 19 were diagnosed with CD.
- MRE demonstrated higher accuracy (98.3%) compared to SBCE (91.9%).
- MRE showed superior sensitivity (100%) and specificity (97.6%) versus SBCE (90.9%, 92.3%).
Conclusions:
- Both MRE and SBCE are accurate for diagnosing pediatric CD.
- MRE is a valuable primary imaging technique, identifying contraindications for SBCE and providing extra-intestinal information.
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.
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