NEW YORK (Reuters Health) – Magnetic resonance enterography (MRE) accurately identifies small-bowel inflammatory activity in patients with Crohn’s disease, researchers from Japan report.
Small-bowel lesions may be present in 70% of Crohn’s disease patients, and deep small-bowel involvement is associated with a poor prognosis. Evaluating these lesions is a critical component of Crohn’s disease management.
Dr. Mamoru Watanabe and colleagues from the School of Medicine, Tokyo Medical and Dental University, in Japan, assessed the importance of small-bowel endoscopic healing using balloon-assisted enteroscopy (BAE) and evaluated the accuracy of MRE for endoscopic healing to predict patient prognosis in a study of 139 patients with Crohn’s disease.
On BAE, 45.3% of patients had small-bowel ulcerative disease and 54.7% had small-bowel endoscopic healing. MRE also identified severe disease in 45.3% of patients and ulcer healing in 54.7%, according to the December 19 online report in the American Journal of Gastroenterology.
Compared with BAE, MRE had 93.4% sensitivity, 81.4% specificity, 95.1% positive predictive value, 76.1% negative predictive value, and 90.9% diagnostic accuracy for ulcer healing.
Patients who did not exhibit small-bowel healing, whether on BAE or MRE, were more likely to experience relapse, hospitalization, and surgery, compared with patients who had endoscopic healing during a median follow-up of 27 months.
During follow-up, MRE and BAE showed similar rates of patients who achieved ulcer healing, whether or not they had ulcerative disease. BAE and MRE also had similar accuracy for predicting clinical relapse, serological relapse, hospitalization, and need for surgery.
“MRE could evaluate small-bowel endoscopic healing with high diagnostic accuracy, and could precisely predict patient outcomes similar to BAE,” the researchers conclude. “Therefore, MR procedures could be considered a valid and reliable examination for small-bowel inflammatory activity.”
Dr. Watanabe did not respond to a request for comment.
SOURCE: http://go.nature.com/2BUiFF4
Am J Gastroenterol 2017.
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