Background and Goals: Magnetic resonance (MR) enterography provides the
advantages of conventional enteroclysis and those of cross-sectional
imaging. Adequate luminal distension, combined with ultrafast sequences,
results in excellent delineation of mural and extramural manifestations
of Crohn's disease. Recent technical advances, including
ultra-high-field strength MR with its capability to provide fast
multiplanar images with excellent soft tissue contrast, are only rarely
included in abdominal studies.
Study: One
hundred four consecutive patients with a proved or suspected diagnosis
of ileitis terminalis were prospectively selected for MR imaging studies
and ileocolonoscopy. The final diagnosis was based on histopathological
findings or based on a combined endpoint of clinical, laboratory,
endoscopic, and imaging findings.
Results:
According to the endoscopic examination, stenosis was present in 26
patients (25%) and could be ruled out in 78 patients (75%). Total
agreement between MR and endoscopy could be reached in 74 patients
(71%). Histology indicated absence of inflammation in 50 patients (48%).
MR and endoscopic findings were concordant in 38 patients (76%) and 37
patients (74%), respectively. Corresponding results by ileocolonoscopy
were 37 true negative, 29 true positive, 4 false positive, and 12 false
negative (sensitivity, 70.7%; specificity, 74%).
Conclusions:
MR enterography with a 3.0-T scanner is a powerful tool in the
evaluation of ileal diseases, and has therefore made MR enterography the
first-line modality at our institution in patients with suspected
inflammatory bowel disease.