Does MR enterography offer added value after a recent CT in the evaluation of abdominal pain in Crohn's disease patients?

Clin Imaging

Yale New Haven Hospital, Department of Radiology and Biomedical Imaging, 20 York Street, New Haven, CT 06520, United States of America. Electronic address:

Published: May 2019


Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Purpose: To determine if there is added value in performing MR enterography shortly after a contrast-enhanced CT of the abdomen and pelvis in patients with Crohn's disease presenting with acute abdominal pain.

Materials And Methods: A total of 45 consecutive patients who underwent MRE examination <7 days after a CT met our strict inclusion criteria. Independent and blinded review of both MRE and CT exams was performed by two abdominal radiologists.

Results: There were no significant differences in detection of various findings associated with Crohn's disease between modalities. These findings included abscess, fistula, bowel wall thickening, free fluid, stricture, and bowel obstruction. There was moderate interobserver agreement with CT (Kappa: 0.52, 95% CI: [0.4-0.6]) and fair with MRE (Kappa: 0.36, 95% CI:[0.3 = 0.5]).

Conclusion: The routine use of MRE after a diagnostic CT should be avoided, as it provides no additional valuable information, at the expense of extra patient risks, discomfort, and higher health care costs.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clinimag.2018.12.002DOI Listing

Publication Analysis

Top Keywords

crohn's disease
8
enterography offer
4
offer evaluation
4
evaluation abdominal
4
abdominal pain
4
pain crohn's
4
disease patients?
4
patients? purpose
4
purpose determine
4
determine performing
4

Similar Publications

Background And Aims: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), remain heterogeneous disorders with variable response to biologics. Post-operative recurrence in CD is common despite surgery and prophylactic biotherapies. Understanding the inflammatory mediators associated with recurrence and treatment response could pave the way for personalized strategies.

View Article and Find Full Text PDF

Background: Few data are available on the impact of primary sclerosing cholangitis (PSC) on inflammatory bowel disease (IBD).

Objective: We conducted a retrospective study using TriNetX to compare the outcomes of patients with IBD and those with concomitant IBD and PSC.

Methods: All patients with a confirmed diagnosis of Crohn's disease (CD), ulcerative colitis (UC), or indeterminate colitis with or without PSC were eligible.

View Article and Find Full Text PDF

Background: Comorbidities and genetic correlations between gastrointestinal tract diseases and psychiatric disorders have been widely reported, but the underlying intrinsic link between Alzheimer's disease (AD) and inflammatory bowel disease (IBD) is not adequately understood.

Methods: To identify pathogenic cell types of AD and IBD and explore their shared genetic architecture, we developed Pathogenic Cell types and shared Genetic Loci (PCGL) framework, which studied AD and IBD and its two subtypes of ulcerative colitis (UC) and Crohn's disease (CD).

Results: We found that monocytes and CD8 T cells were the enriched pathogenic cell types of AD and IBDs, respectively.

View Article and Find Full Text PDF

Background: Proactive therapeutic drug monitoring (TDM) for tumor necrosis factor alpha antagonist (anti-TNF) therapy in adult inflammatory bowel disease (IBD) remains controversial, with inconsistent findings from clinical trials and meta-analyses. Pediatric societal guidelines endorse the implementation of proactive TDM. However, the integration of TDM into clinical practice by pediatric gastroenterologists has not been characterized.

View Article and Find Full Text PDF