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Magnetic resonance enterography guiding treatment in children with Crohn's jejunoileitis
M Piekkala1, T Kalajoki-Helmiö, L Martelius
1Children's Hospital, University of Helsinki, Finland. maija.piekkala@helsinki.fi
Insights
Magnetic resonance enterography (MRE) effectively identifies small bowel Crohn's disease in children. This imaging technique aids in treatment decisions, including medication adjustments and surgical needs.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
Background:
- Crohn's disease is a chronic inflammatory condition affecting the gastrointestinal tract.
- Accurate assessment of small bowel involvement is crucial for effective management in pediatric patients.
Purpose of the Study:
- To evaluate the utility of magnetic resonance enterography (MRE) in managing pediatric Crohn's disease.
- To determine if MRE findings correlate with treatment decisions and surgical necessity.
Main Methods:
- 45 pediatric Crohn's disease patients underwent MRE to assess small bowel involvement.
- Two independent radiologists evaluated MRE images.
- MRE findings were compared with surgical or endoscopic macroscopic findings.
Main Results:
- MRE successfully visualized the terminal ileum in 43 out of 45 patients.
- Treatment remained conservative in 74% of patients post-MRE.
- MRE findings correlated well with macroscopic findings (73%), sometimes indicating more extensive disease.
Conclusions:
- Magnetic resonance enterography is valuable for detecting small bowel Crohn's disease in children.
- MRE findings can guide therapeutic strategies, including medication adjustments and surgical planning.
Aim:
To determine the usefulness of magnetic resonance enterography (MRE) in treatment for paediatric patients with Crohn's disease.
Methods:
To evaluate small bowel involvement, 45 children with Crohn's disease were scheduled for MRE. Two radiologists blinded to the patient data independently re-evaluated the images. Findings in images were compared to macroscopic findings at surgery or endoscopy.
Results:
The terminal ileum was visualized in all with a completed procedure (43/45). The treatment remained conservative in 74% after imaging. In all 13 patients who underwent ileocolonoscopy within 3 months of MRE, the MRE findings were comparable with the macroscopic findings or revealed a more extensive disease. Bowel resection was performed in 26% after imaging. The macroscopic findings in the bowel corresponded to the MRE findings in 73%. In three MRE suggested a more severe disease than was verified intraoperatively.
Conclusions:
Magnetic resonance enterography identifies disease involvement in the small bowel in young patients with Crohn's disease and may guide decisions on the need for intestinal surgery or adjustment of medication.
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