Magnetic resonance enterography and wireless capsule endoscopy in the evaluation of patients with inflammatory bowel disease

Abstract

Background: Magnetic resonance enterography (MRE) is increasingly used in children due to growing concerns of radiation.

Objective: To determine the performance of MRE, imaging findings were compared to wireless capsule endoscopy (WCE) and histology results in children with/or suspected inflammatory bowel disease (IBD).

Materials and methods: Pathology and WCE reports were retrospectively reviewed in 23 patients who had MRE.

Results: The sensitivity of MRE was 75.0% while the sensitivity of WCE was 77.8%.

Conclusion: MRE and WCE are complementary techniques in evaluation of the small bowel in IBD.

Copyright © 2013 Elsevier Inc. All rights reserved.

Figures

Figure 1

Pre (a) and post-contrast (b) coronal LAVA images demonstrate mucosal enhancement, wall thickening, and vascular dilatation and tortuosity of the vasa recta (comb sign). Axial LAVA image (c) demonstrates wall thickening and striated mucosal enhancement. Capsule endoscopy (d) shows an edematous, ulcerated small bowel with loss of normal villi. The terminal ileum is erythematous with erosions, edema, hemorrhage, and purulent exudate. Histopathology at 40 × magnification (e) shows a friable, edematous ulcer of the terminal ileum with purulent exudate and granulomatous change.

Figure 2

Pre (a) and post-contrast (b) coronal LAVA images demonstrate mucosal enhancement and wall thickening of the cecum and terminal ileum. Axial post contrast LAVA image (c) demonstrates thickening of the cecum and terminal ileum with striated enhancement. Axial noncontrast FIESTA images (d, e) show terminal ileal wall thickening with luminal narrowing and proximal dilatation. Histopathology at 40× (f) shows active ileitis with friable mucosa, cobblestoning, and hemorrhage.

Figure 3

ROC Analysis for MR Score and E/H score (E/H score was dichotomized as 1–6 vs. 8–10) in the terminal ileum subgroup.