Comparison of magnetic resonance imaging and endoscopy in distinguishing the type and severity of inflammatory bowel disease.

Abstract:

:Twenty consecutive patients with first-time presentation of suspected inflammatory bowel disease underwent both endoscopy with biopsy and magnetic resonance imaging (MRI) within a 3-day period; the relative abilities of endoscopy and MRI to distinguish ulcerative colitis (UC) from Crohn's disease (CD) and to determine the severity of the disease process were compared. In 18 of 20 patients, a diagnosis of UC or CD could be made on histological specimens. MRI correctly diagnosed 17 of these 18 patients using T1-weighted fat-suppressed spin echo and gadolinium enhancement. Endoscopy correctly diagnosed 15 patients. Overall, MRI was not significantly better (p > 0.05) than endoscopy in distinguishing UC from CD. MRI correctly graded the severity of inflammatory changes in 13 of 20 patients, and endoscopy did so in 11 of 20. MRI and endoscopy findings were within one grade of histology findings in seven patients each. No significant difference (p > 0.05) was found between MRI and endoscopy in the ability to estimate the severity of the disease (as determined from biopsies). Bowel wall thickness measured on MR images demonstrated good correlation with percentage of contrast enhancement: r = 0.61; p = 0.003. In sum, magnetic resonance imaging was shown to be comparable with endoscopy in differentiating UC from CD and in gauging the severity of disease. Transmural assessment, sagittal imaging, and the lack of invasiveness were attractive features of MRI.

journal_name

J Clin Gastroenterol

authors

Shoenut JP,Semelka RC,Magro CM,Silverman R,Yaffe CS,Micflikier AB

doi

10.1097/00004836-199407000-00009

subject

Has Abstract

pub_date

1994-07-01 00:00:00

pages

31-5

issue

1

eissn

0192-0790

issn

1539-2031

journal_volume

19

pub_type

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