MRI trumps ultrasound in diagnosing Crohn's disease
MRI may be more expensive than ultrasound, but it should become the imaging modality of choice for patients with suspected Crohn's disease, according to German researchers.
Led by Dr. Silke Potthast, researchers from the Universitat Ulm examined the localization of Crohn's lesions in 46 patients who underwent both MRI and ultrasound. Also analyzed in the study were the number of affected bowel segments, the number of stenoses, and the presence of abscesses, fistulae, and any additional findings. The researchers verified their findings by one or more of the following: · enteroclysis · surgical findings · colonoscopy
Results showed that MRI is superior to ultrasound in the localization of affected bowel segments, featuring a sensitivity of 97.5% compared with 76% for ultrasound. MRI's sensitivity in recognizing fistulae was 87%, compared with ultrasound's 31%. MRI scored a perfect 100% in sensitivity for discovering both stenoses and abscesses, compared with 58% and 89% for ultrasound, respectively.
MRI is also preferred over CT, as many patients with Crohn's disease are young adults and MRI doesn't involve any of CT's radiation issues, according to Potthast. The study was published in the June issue of European Radiology.
The researchers suggest that abdominal MRI should be used to clarify any discrepancies in clinical and sonographic findings. Because the modality has such a high accuracy, they further suggest using MR first for patients in whom Crohn's lesions are known or suspected close to the terminal or neoterminal ileum and in cases with suspected fistulae and abscesses.
"In general the gold standard today is the enteroclysma. The new gold standard -- MRI -- should be accepted," said Potthast.
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