Systematic review with meta-analysis: magnetic resonance enterography signs for the detection of inflammation and intestinal damage in Crohn's disease

Introduction. Crohn’s disease is most commonly found in the terminal ileum and colonic region. Magnetic resonance has become a useful modality for assessing small bowel activity. In this study, we performed a systematic review and meta-analysis on the use of MR in detecting small bowel activity as well as extramural complications in Crohn’s patients.Methods. Two independent reviewers sorted through articles until October 2, 2014. We included both studies providing raw data for pooling and studies without raw data. Sensitivity, specificity, likelihood ratios, and 95% confidence intervals were calculated for each study.Results. There were 27 included studies, of which 19 were included in the pooled analysis. Pooled analysis of the 19 studies (1020 patients) with raw data revealed a sensitivity of 0.88 (95% CI 0.86 to 0.91) and specificity was 0.88 (95% CI 0.84 to 0.91). In regard to detecting stenosis, pooled sensitivity was 0.65 (95% CI 0.53 to 0.76) and specificity was 0.93 (95% CI 0.89 to 0.96).Conclusion. MR imaging provides a reliable alternative in detecting small bowel activity in patients with Crohn’s disease. Its advantages include high diagnostic accuracy and no radiation exposure while its disadvantages include high cost and limited availability.

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Magnetic resonance imaging in the management of Crohn’s disease: a systematic review and meta-analysis

Insights into Imaging ◽

10.1186/s13244-021-01064-9 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Rani Ahmad ◽

Amr M. Ajlan ◽

Ayman A. Eskander ◽

Turki A. Alhazmi ◽

Khalid Khashoggi ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Systematic Review ◽

Crohn’S Disease ◽

Magnetic Resonance ◽

Small Bowel ◽

Crohn's Disease ◽

Meta Analysis ◽

Pooled Analysis ◽

Resonance Imaging ◽

Good Diagnostic Accuracy

Abstract Objectives Crohn’s disease (CD) is a condition that can occur in any part of the gastrointestinal tract, although usually forms in the colon and terminal ileum. Magnetic resonance imaging (MRI) has become a beneficial modality in the evaluation of small bowel activity. This study reports on a systematic review and meta-analysis of magnetic resonance enterography for the prediction of CD activity and evaluation of outcomes and possible complications. Methods Following the PRISMA guidelines, a total of 25 low-risk studies on established CD were selected, based on a QUADAS-II score of ≥ 9. Results A sensitivity of 90% was revealed in a pooled analysis of the 19 studies, with heterogeneity of χ2 = 81.83 and I2 of 80.3%. Also, a specificity of 89% was calculated, with heterogeneity of χ2 = 65.12 and I2 of 70.0%. Conclusion It was concluded that MRI provides an effective alternative to CT enterography in the detection of small bowel activity in CD patients under supervision of radiologist for assessment of disease activity and its complications. Its advantages include the avoidance of radiation exposure and good diagnostic accuracy.

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Capsule Endoscopy, Magnetic Resonance Enterography, and Small Bowel Ultrasound for Evaluation of Postoperative Recurrence in Crohn’s Disease: Systematic Review and Meta-Analysis

Inflammatory Bowel Diseases ◽

10.1093/ibd/izx027 ◽

2017 ◽

Vol 24 (1) ◽

pp. 93-100 ◽

Cited By ~ 10

Author(s):

Diana E Yung ◽

Ofir Har-Noy ◽

Yuen Sau Tham ◽

Shomron Ben-Horin ◽

Rami Eliakim ◽

...

Keyword(s):

Crohn’S Disease ◽

Magnetic Resonance ◽

Crohn's Disease ◽

Capsule Endoscopy ◽

Meta Analysis ◽

Area Under The Curve ◽

Postoperative Recurrence ◽

Magnetic Resonance Enterography ◽

Ileocecal Resection ◽

Endoscopic Recurrence

Abstract Background Anastomotic recurrence is frequent in patients with Crohn’s disease (CD) following ileocecal resection. The degree of endoscopic recurrence, quantified by the Rutgeerts score (RS), is correlated with the risk of clinical and surgical recurrence. Noninvasive modalities such as capsule endoscopy (CE), magnetic resonance enterography (MRE), and intestinal ultrasound (US) may yield similar information without the need for ileocolonoscopy (IC). The aim of our meta-analysis was to evaluate the accuracy of those modalities for detection of endoscopic recurrence in postoperative CD patients. Methods We performed a systematic literature search for studies comparing the accuracy of CE, MRE, and US with IC for detection of postoperative recurrence in CD. We calculated pooled diagnostic sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) for each comparison. Results A total of 135 studies were retrieved; 14 studies were eligible for analysis. For CE, the pooled sensitivity was 100% (95% CI, 91%–100%), specificity was 69% (95% CI, 52%–83%), DOR was 30.8 (95% CI, 6.9–138), and AUC was 0.94. MRE had pooled sensitivity of 97% (95% CI, 89%–100%), specificity of 84% (95% CI, 62%–96%), DOR of 129.5 (95% CI, 16.4–1024.7), and AUC of 0.98. US had pooled sensitivity of 89% (95% CI, 85%–92%), specificity of 86% (95% CI, 78%–93%), DOR of 42.3 (95% CI, 18.6–96.0), and AUC 0.93. Conclusions CE, MRE, and US provide accurate assessment of postoperative endoscopic recurrence in CD. These modalities should gain wider use for detection of postoperative recurrence; the prognostic value of those diagnostic findings merits evaluation in further prospective studies.

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