| 1. Cosnes J, Gower-Rousseau C, Seksik P, Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology. 2011;140(6):1785-1794. |
Review/Other-Dx |
N/A |
To determine the epidemiology of IBDs. |
No results stated in abstract. |
4 |
| 2. Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142(1):46-54 e42; quiz e30. |
Review/Other-Dx |
260 studies |
A systematic review to determine changes in the worldwide incidence and prevalence of UC and CD in different regions and with time. |
The highest annual incidence of UC was 24.3 per 100,000 person-years in Europe, 6.3 per 100,000 person-years in Asia and the Middle East, and 19.2 per 100,000 person-years in North America. The highest annual incidence of CD was 12.7 per 100,000 person-years in Europe, 5.0 person-years in Asia and the Middle East, and 20.2 per 100,000 person-years in North America. The highest reported prevalence values for IBD were in Europe (UC, 505 per 100,000 persons; CD, 322 per 100,000 persons) and North America (UC, 249 per 100,000 persons; CD, 319 per 100,000 persons). In time-trend analyses, 75% of CD studies and 60% of UC studies had an increasing incidence of statistical significance (P<.05). |
4 |
| 3. Loftus CG, Loftus EV, Jr., Harmsen WS, et al. Update on the incidence and prevalence of Crohn's disease and ulcerative colitis in Olmsted County, Minnesota, 1940-2000. Inflamm Bowel Dis. 2007;13(3):254-261. |
Review/Other-Dx |
1940–2000; 308 residents diagnosed with CD and 372 with UC |
An update on the incidence and prevalence of CD and UC in Olmsted County, Minnesota. |
From 1990-2000 the adjusted annual incidence rates for UC and CD were 8.8 cases per 100,000 (95% CI, 7.2–10.5) and 7.9 per 100,000 (95% CI, 6.3–9.5), respectively, not significantly different from rates observed in 1970-1979. On January 1, 2001, there were 220 residents with CD, for an adjusted prevalence of 174 per 100,000 (95% CI, 151–197), and 269 residents with UC, for an adjusted prevalence of 214 per 100,000 (95% CI, 188–240). Although incidence rates of CD and UC increased after 1940, they have remained stable over the past 30 years. Since 1991 the prevalence of UC decreased by 7%, and the prevalence of CD increased about 31%. Extrapolating these figures to U.S. Census data, there were approximately 1.1 million people with IBD in the U.S. in 2000. |
4 |
| 4. Gollop JH, Phillips SF, Melton LJ, 3rd, Zinsmeister AR. Epidemiologic aspects of Crohn's disease: a population based study in Olmsted County, Minnesota, 1943-1982. Gut. 1988;29(1):49-56. |
Review/Other-Dx |
N/A |
To determine the epidemiologic aspects of CD in patients. |
The overall age and sex adjusted incidence of CD among Olmsted County, Minnesota, residents was 4.0 per 100,000 person-year in the period 1943–1982. Ileitis, ileocolitis, and colitis each accounted for about one third of the 103 incidence cases. Incidence rates were greater in woman than men, were higher in the urban portions of the county, and rose over time. Overall, the natural history of CD in the community may be milder than that reported for patients at referral centers, as over half of all patients had no complications and only a third required surgery for CD. Only 1 developed adenocarcinoma of the colon (relative risk = 2.0, NS). Survival was relatively unimpaired for the cohort, but CD may have played a role in half of the deaths. The prevalence of CD was 90.5/100,000 population on 1 January 1980. |
4 |
| 5. Henriksen M, Jahnsen J, Lygren I, et al. Clinical course in Crohn's disease: results of a five-year population-based follow-up study (the IBSEN study). Scand J Gastroenterol. 2007;42(5):602-610. |
Review/Other-Dx |
416 patients |
To analyze disease phenotypes and progression of childhood-onset disease and compared them with characteristics of adult-onset disease in patients in Scotland. |
At the time of diagnosis in children, CD involved small bowel and colon (L3) in 51% (138/273), colon (L2) in 36%, and ileum (L1) in 6%; the UGI tract (L4) was also affected in 51%. In 39%, the anatomic extent increased within 2 years. Behavioral characteristics progressed; 24% of children developed stricturing or penetrating complications within 4 years (vs 9% at diagnosis; P<.0001; OR, 3.32; 95% CI, 1.86–5.92). Compared with adults, childhood-onset disease was characterized by a “panenteric” phenotype (ileocolonic plus UGI [L3+L4]; 43% vs 3%; P<.0001; OR, 23.36; 95% CI, 13.45–40.59) with less isolated ileal (L1; 2% vs 31%; P<.0001; OR, 0.06; 95% CI, 0.03–0.12) or colonic disease (L2; 15% vs 36%; P<.0001; OR, 0.31; 95% CI, 0.21–0.46). UC was extensive in 82% of the children at diagnosis, vs 48% of adults (P<.0001; OR, 5.08; 95% CI, 2.73–9.45); 46% of the children progressed to develop extensive colitis during follow-up. 46% of children with CD and 35% with UC required immunomodulatory therapy within 12 months of diagnosis. The median time to first surgery was longer in childhood-onset than adult-onset patients with CD (13.7 vs 7.8 years; P<.001); the reverse was true for UC. |
4 |
| 6. Sheedy SP, Bruining DH, Dozois EJ, Faubion WA, Fletcher JG. MR Imaging of Perianal Crohn Disease. [Review]. Radiology. 282(3):628-645, 2017 Mar. |
Review/Other-Dx |
N/A |
To summarize current imaging strategies and objectives in patients with perianal Crohn disease (CD), focusing on modern therapeutic strategies and imaging findings, which will assist the gastroenterologist and surgeon in planning palliative or curative treatment options. |
No results stated in abstract |
4 |
| 7. Gomollon F, Dignass A, Annese V, et al. 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management. J Crohns Colitis. 11(1):3-25, 2017 Jan. |
Review/Other-Dx |
N/A |
Evidence-based consensus on the diagnosis and management of Crohn’s disease, concerns the methodology of the consensus process, and the classification, diagnosis and medical management of active and quiescent Crohn’s disease. |
No results stated in abstract |
4 |
| 8. Pariente B, Mary JY, Danese S, et al. Development of the Lemann index to assess digestive tract damage in patients with Crohn's disease. Gastroenterology. 148(1):52-63.e3, 2015 Jan. |
Observational-Dx |
138 patients |
To report the development and the first validation of the Lémann Index, the first global Crohn’s disease (CD) damage index assessing cumulative structural bowel damage in CD. |
Data from 138 patients (24, 115, 92, and 59 with upper tract, small bowel, colon/rectum, and anus CD location, respectively) were analyzed. According to validation, the unbiased correlation coefficients between predicted indexes and investigator damage evaluations were 0.85, 0.98, 0.90, 0.82 for upper tract, small bowel, colon/rectum, anus, respectively, and 0.84 overall. |
3 |
| 9. Panes J, Bouhnik Y, Reinisch W, et al. Imaging techniques for assessment of inflammatory bowel disease: joint ECCO and ESGAR evidence-based consensus guidelines. J Crohns Colitis. 7(7):556-85, 2013 Aug. |
Review/Other-Dx |
N/A |
To establish standards for imaging in IBD using magnetic resonance imaging (MRI), computed tomography (CT), ultrasonography (US), and including also other radiologic procedures such as conventional radiology or nuclear medicine examinations, but not endoscopy, although considerations on the relative value of endoscopy and radiology in different clinical settings are provided in the consensus |
No results stated in abstract |
4 |
| 10. Samuel S, Bruining DH, Loftus EV Jr, et al. Endoscopic skipping of the distal terminal ileum in Crohn's disease can lead to negative results from ileocolonoscopy. Clin Gastroenterol Hepatol. 10(11):1253-9, 2012 Nov. |
Observational-Dx |
189 consecutive patients |
To analyze advanced cross-sectional images to determine how frequently this occurs. |
Of the patients evaluated, 153 underwent TI intubation during endoscopy; 67 of these (43.8%) had normal results from ileoscopy, based on endoscopic appearance. Despite their normal results from ileoscopy, 36 of these patients (53.7%) had active, small-bowel CD. The ileum appeared normal at ileoscopy because the disease had skipped the distal ileum of 11 patients (30.6%), developed only in the intramural and mesenteric distal ileum of 23 patients (63.9%), and appeared only in the UGI region of 2 patients (5.6%). These patients had a shorter duration of disease (61.1% for <5 years) compared with those found to have CD based on ileoscopy (41.1% for <5 years; P<.05). CT enterography detected extracolonic CD in 26% of patients; 14% of patients were found to have disorders unrelated to IBD that warranted further investigation or consultation (including 4 cancers). |
4 |
| 11. Magarotto A, Orlando S, Coletta M, Conte D, Fraquelli M, Caprioli F. Evolving roles of cross-sectional imaging in Crohn's disease. [Review]. Dig Liver Dis. 48(9):975-83, 2016 Sep. |
Review/Other-Dx |
N/A |
To the evolving applications of imaging in Crohn’s disease(CD), with a particular emphasis on the most recent technological advances in cross-sectional imaging. |
No results stated in abstract |
4 |
| 12. Froslie KF, Jahnsen J, Moum BA, Vatn MH. Mucosal healing in inflammatory bowel disease: results from a Norwegian population-based cohort. Gastroenterology. 2007;133(2):412-422. |
Observational-Dx |
495 patients |
To examine both the possible predictors of mucosal healing and the impact of healing on subsequent course of disease. |
In UC patients, education longer than 12 years and extensive disease at diagnosis were significant predictors of mucosal healing after 1 year (adjusted P=.004 and P=.02, respectively). Mucosal healing was significantly associated with a low risk of future colectomy (P=.02). In patients with CD, fever at diagnosis and medical treatment without steroids were significant predictors for mucosal healing (adjusted P=.03 and P=.01, respectively). Mucosal healing was significantly associated with less inflammation after 5 years (P=.02), decreased future steroid treatment (P=.02). |
3 |
| 13. Deepak P, Fletcher JG, Fidler JL, et al. Radiological Response Is Associated With Better Long-Term Outcomes and Is a Potential Treatment Target in Patients With Small Bowel Crohn's Disease. Am J Gastroenterol. 111(7):997-1006, 2016 Jul. |
Observational-Dx |
150 patients |
To evaluate long-term disease progression using radiological response as a treatment end point in a cohort of small bowel Crohn’s disease (CD) patients. |
CD patients ( n =150), with a median disease duration of 9 years, had 223 inflamed smallsegments(76 with strictures and 62 with penetrating, non-perianal disease), 49% having ileal distribution. Fifty-fi ve patients (37%) were complete radiologic responders, 39 partial (26%), and 56 non-responders (37%). In multivariable Cox models, complete and partial response decreased risk for steroid usage by over 50% (hazard ratio (HR)s: 0.37 (95% confidence interval (CI),0.21–0.64); 0.45 (95% CI, 0.26–0.79)), and complete response decreased the risk of subsequent hospitalizations and surgery by over two-thirds (HRs: HR, 0.28 (95% CI, 0.15–0.50); HR, 0.34 (95% CI, 0.18–0.63)). |
2 |
| 14. Hashimoto S, Shimizu K, Shibata H, et al. Utility of computed tomographic enteroclysis/enterography for the assessment of mucosal healing in Crohn's disease. Gastroenterol Res Pract. 2013:984916, 2013. |
Observational-Dx |
39 patients |
To compare findings from computed tomographic enteroclysis/enterography (CTE) with those from the mucosal surface and to determine whether the stateof mucosal healing can be determined by CTE |
According to the CTE findings, patients were determined to be in the active CD group (?? = 31) or inactive CD group (?? = 8). The proportion of previous surgery, clinical remission, stenosis, and CDAI score all showed significant difference between groups. Mucosal findings showed an association with ulcer in 93.6% of active group patients but in only 12.5% of inactive group patients (?? < 0.0001), whereas mucosal healing was found in 62.5% of inactive group patients but in only 3.2% of active group patients (?? < 0.0001). |
3 |
| 15. Fletcher JG, Fidler JL, Bruining DH, Huprich JE. New concepts in intestinal imaging for inflammatory bowel diseases. [Review]. Gastroenterology. 140(6):1795-806, 2011 May. |
Review/Other-Dx |
N/A |
To review new, emerging roles in detecting clinically occult inflammation (in asymptomatic patients) and inflammatory complications, predicting responseprior to therapy, assessing response after therapy, and enteric healing. |
No results stated in abstract |
4 |
| 16. Furukawa A, Saotome T, Yamasaki M, et al. Cross-sectional imaging in Crohn disease. [Review] [40 refs]. Radiographics. 24(3):689-702, 2004 May-Jun. |
Review/Other-Dx |
N/A |
To review various imaging considerations in the diagnosis and evaluation of Crohn disease, including preparations, contrast agents, and scanning techniques. |
No results stated in abstract |
4 |
| 17. Negaard A, Sandvik L, Berstad AE, et al. MRI of the small bowel with oral contrast or nasojejunal intubation in Crohn's disease: randomized comparison of patient acceptance. Scand J Gastroenterol. 2008;43(1):44-51. |
Observational-Dx |
38 patients |
Randomized study to evaluate the compliance of CD patients examined with MRI of the small bowel with an oral contrast (MRI per os) or installation of the contrast in a nasojejunal catheter. |
Abdominal pain and discomfort were lower with MRI per os than with contrast in a nasojejunal catheter (mean visual analogue scale pain score immediately after: 10 mm and 33 mm, respectively, P<0.001; mean visual analogue scale discomfort score 24 hours after: 18 mm and 62 mm, respectively, P<0.001). Nausea and abdominal pain were correlated with overall discomfort after MRI per os (r=0.56 for both, P<0.001). No symptoms were significantly correlated with discomfort experienced with contrast in a nasojejunal catheter. More patients accepted repeat MRI per os examination (n=36) than contrast in a nasojejunal catheter (n=22, P=0.001). Patients preferred and experienced less abdominal pain and discomfort with MRI per os than with contrast in a nasojejunal catheter. |
3 |
| 18. Wold PB, Fletcher JG, Johnson CD, Sandborn WJ. Assessment of small bowel Crohn disease: noninvasive peroral CT enterography compared with other imaging methods and endoscopy--feasibility study. Radiology. 2003; 229(1):275-281. |
Observational-Dx |
23 patients |
Comparative study to evaluate two biphasic CT enterography protocols, a noninvasive CT technique with water administered perorally and CT enteroclysis with methylcellulose administered through a nasojejunal tube. |
Arterial phase imaging was noncontributory in 22/23 cases. Noninvasive per-oral water CT enterography protocol had similar accuracy (12/15 cases, 80%) for enabling the detection of active Crohn disease in comparison with CT enteroclysis with nasojejunal tube (7/8, 88%) and fluoroscopic small bowel examination (17/23, 74%). No fistulas were missed with use of either CT technique. Noninvasive per-oral portal venous phase CT enterography with use of water is accurate and feasible. |
2 |
| 19. Erturk SM, Mortele KJ, Oliva MR, et al. Depiction of normal gastrointestinal anatomy with MDCT: comparison of low- and high-attenuation oral contrast media. Eur J Radiol. 2008;66(1):84-87 |
Observational-Dx |
90 consecutive patients |
To compare low- and high-attenuation oral contrast media for depiction of normal gastrointestinal anatomy with MDCT. |
Duodenal, jejunal and ileal distention (P<0.05, <0.001, <0.001, respectively) and wall visualization (P<0.05, <0.01, <0.05, respectively) scores with low-attenuation contrast medium were significantly higher than those with high-attenuation barium sulphate preparation, for reader 1. Duodenal and jejunal wall visualization scores with low-attenuation contrast medium (P<0.05, <0.01, respectively) were significantly higher than those with high-attenuation contrast medium, for reader 2. Interobserver agreement was fair to good for both distention (kappa-range: 0.41–0.74) and wall visualization (kappa-range: 0.48–0.71). |
2 |
| 20. Huprich JE, Fletcher JG. CT enterography: principles, technique and utility in Crohn's disease. Eur J Radiol. 2009;69(3):393-397. |
Review/Other-Dx |
N/A |
To discuss the essential principles of the exam and its use in the evaluation of CD of the small bowel. |
The benefit of CT enterography is recognized at many institutions where it has become a primary diagnostic tool in CD. The application of the principles outlined herein will hopefully encourage more widespread use of this robust technique in the clinical evaluation of small bowel disease. |
4 |
| 21. Guidi L, Minordi LM, Semeraro S, et al. Clinical correlations of small bowel CT and contrast radiology findings in Crohn's disease. Eur Rev Med Pharmacol Sci. 2004;8(5):215-217. |
Observational-Dx |
35 patients |
Compare CT with positive oral contrast with barium small bowel exams and correlated with CDAI. |
Sensitivity of small bowel CT vs endoscopy was 88% while sensitivity of barium studies was 77% vs endoscopic findings, and reached 100% for the combination of both exams. Small bowel CT is a useful adjunct to conventional barium studies and CT findings correlate with CDAI. |
3 |
| 22. Vandenbroucke F, Mortele KJ, Tatli S, et al. Noninvasive multidetector computed tomography enterography in patients with small-bowel Crohn's disease: is a 40-second delay better than 70 seconds? Acta Radiol. 2007;48(10):1052-1060. |
Observational-Dx |
26 patients |
To determine the optimal delay time to image patients with small-bowel CD during MDCT enterography. |
No statistically significant difference was present between the enteric and the parenchymal phase for each reader in each segment regarding the presence or absence of CT features of CD. The interobserver agreement for the presence of 5 main features of active CD in the terminal ileum ranged from poor to excellent. The sensitivity, specificity, NPV, PPV, and accuracy for active CD in the terminal ileum ranged from 40% to 90%, 88% to 100%, 70% to 94%, 44% to 100%, and 69% to 96%, respectively. There was no statistical difference between the 2 phases for each reader. |
2 |
| 23. Boudiaf M, Jaff A, Soyer P, Bouhnik Y, Hamzi L, Rymer R. Small-bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients. Radiology. 2004; 233(2):338-344. |
Observational-Dx |
107 consecutive patients |
To prospectively evaluate MDCT enteroclysis for the depiction of small bowel disease. |
Sensitivity, specificity, accuracy, PPV, and NPV of MDCT enteroclysis were 100%, 95%, 97%, 94%, and 100%, respectively. MDCT enteroclysis allows depiction of a variety small bowel diseases in patients suspected of having small bowel disease. |
2 |
| 24. Qiu Y, Mao R, Chen BL, et al. Systematic review with meta-analysis: magnetic resonance enterography vs. computed tomography enterography for evaluating disease activity in small bowel Crohn's disease. [Review]. Aliment Pharmacol Ther. 40(2):134-46, 2014 Jul. |
Meta-analysis |
6 studies, 290 patients |
To compare the overall diagnostic accuracy in assessing the activity of small bowel and complications. |
A total of 290 CD patients from six different studies were analysed. The pooled sensitivity and specificity for MRE in detecting active small bowel CD was87.9% [95% confidence interval (CI), 81.8–92.5] and 81.2% (95% CI: 71.9–88.4) respectively. The AUC under the summary receiver-operating characteristic(sROC) of MRE was 0.905 (SEM 0.03, standard error of the mean). Likewise, the pooled sensitivity and specificity of CTE in detecting active small bowel CDwas 85.8% (95% CI: 79.2–90.9) and 83.6% (95% CI: 75.3–90.1) with the AUC of 0.898. The AUC of MRE in detecting fistula, stenosis and abscess was 0.936,0.931 and 0.996, respectively, compared to 0.963, 0.616 and 0.899 of CTE. No statistically significant IY for MRE vs. CTE was found (fixed model, P > 0.05). |
Good |
| 25. Bodily KD, Fletcher JG, Solem CA, et al. Crohn Disease: mural attenuation and thickness at contrast-enhanced CT Enterography--correlation with endoscopic and histologic findings of inflammation. Radiology. 2006;238(2):505-516. |
Observational-Dx |
96 patients |
Retrospective study to determine if quantitative measures of small bowel mural attenuation and thickness at CT enterography correlate with endoscopic and histologic findings in CD. |
Quantitative measures of nural attenuation and wall thickness at CT enterography correlate highly with ileoscopic and histologic findings of inflammatory CD. |
2 |
| 26. Booya F, Fletcher JG, Huprich JE, et al. Active Crohn disease: CT findings and interobserver agreement for enteric phase CT enterography. Radiology. 2006;241(3):787-795. |
Observational-Dx |
42 patients |
To retrospectively evaluate small-bowel enhancement characteristics and the sensitivity, specificity, and interobserver agreement of CT findings in patients undergoing enteric phase CT enterography. Reference standard were histologic and endoscopic results. |
Distended jejunal loops had significantly greater attenuation than distended ileal loops (113 HU vs 72 HU; P<.001). Attenuation of collapsed jejunal (134 HU) and ileal (108 HU) loops was greater than that of distended jejunal and ileal loops. Mural hyper-enhancement and increased mural thickness are the most sensitive CT findings of active CD. |
2 |
| 27. Lee SS, Kim AY, Yang SK, et al. Crohn disease of the small bowel: comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. Radiology. 2009;251(3):751-761. |
Observational-Dx |
30 patients with CD, 2 independent readers |
To prospectively compare the accuracy of CT and MR enterography and SBFT examination for detection of active small-bowel inflammation and extraenteric complications in patients with CD. Ileocolonoscopic findings served as the reference standard. Readers were blinded to clinical findings, findings at ileocolonoscopic assessment, and results of other imaging examinations. |
Differences in areas under the ROC curves for CT enterography (0.900 and 0.894), MR enterography (0.933 and 0.950), and SBFT (0.883 and 0.928) for readers 1 and 2, respectively, in the detection of active terminal ileitis were not significant (P>.017). Sensitivity values for detection of extraenteric complications were significantly higher for CT and MR enterography (100% for both) than they were for SBFT (32% for reader 1 and 37% for reader 2) (P<.001). Because MR enterography has a diagnostic effectiveness comparable to that of CT enterography, this technique has potential to be used as a radiation-free alternative for evaluation of patients with CD. |
1 |
| 28. Horsthuis K, Bipat S, Bennink RJ, Stoker J. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology. 2008;247(1):64-79 |
Meta-analysis |
33 studies |
To compare, by performing a meta-analysis, the accuracies of US, MRI, scintigraphy, CT, and PET in the diagnosis of IBD. |
33 studies, from a search that yielded 1,406 articles, were included in the final analysis. Mean sensitivity estimates for the diagnosis of IBD on a per-patient basis were high and not significantly different among the imaging modalities (89.7%, 93.0%, 87.8%, and 84.3% for US, MRI, scintigraphy, and CT, respectively). Mean per-patient specificity estimates were 95.6% for US, 92.8% for MRI, 84.5% for scintigraphy, and 95.1% for CT; the only significant difference in values was that between scintigraphy and US (P=.009). Mean per-bowel-segment sensitivity estimates were lower: 73.5% for US, 70.4% for MRI, 77.3% for scintigraphy, and 67.4% for CT. Mean per-bowel-segment specificity estimates were 92.9% for US, 94.0% for MRI`, 90.3% for scintigraphy, and 90.2% for CT. CT proved to be significantly less sensitive and specific compared with scintigraphy (P=.006) and MRI (P=.037). |
M |
| 29. Bruining DH, Siddiki HA, Fletcher JG, Tremaine WJ, Sandborn WJ, Loftus EV, Jr. Prevalence of penetrating disease and extraintestinal manifestations of Crohn's disease detected with CT enterography. Inflamm Bowel Dis. 2008;14(12):1701-1706. |
Review/Other-Dx |
357 consecutive patients |
To determine the prevalence of penetrating disease and extraintestinal manifestations of CD identified by CT enterography. Study also examined the percentage of clinically significant new non-IBD related findings in these patients. |
Of 357 patients identified (51% female) the median age was 41.6 years and median disease duration was 9.9 years. Of this cohort, 20.7% had penetrating disease (new finding in 58.1%) and 18.8% had extraintestinal IBD manifestations (new finding in 67.2%). 6 patients had primary sclerosing cholangitis and portal/mesenteric vein thrombosis, respectively. 45.1% had non-IBD findings including 2 unsuspected malignancies. Most of these extraenteric non-IBD abnormalities were benign, with only 13.0% requiring urgent follow-up. CT enterography is a valuable diagnostic modality for detecting both penetrating disease and extraintestinal IBD manifestations. These data add to a growing body of evidence that supports the use of CT enterography in CD diagnostic and management algorithms. |
4 |
| 30. Doerfler OC, Ruppert-Kohlmayr AJ, Reittner P, Hinterleitner T, Petritsch W, Szolar DH. Helical CT of the small bowel with an alternative oral contrast material in patients with Crohn disease. Abdom Imaging. 28(3):313-8, 2003 May-Jun. |
Observational-Dx |
38 patients |
Assess usefulness of helical CT with negative oral contrast compared to tube enteroclysis in detecting CD. |
Sensitivity of CT for detection of CD was superior to tube enteroclysis (89% vs 78%). CT is a simple, rapid, noninvasive, and accurate method of evaluating extramucosal manifestations of CD. |
3 |
| 31. Higgins PD, Caoili E, Zimmermann M, et al. Computed tomographic enterography adds information to clinical management in small bowel Crohn's disease. Inflamm Bowel Dis. 2007;13(3):262-268. |
Observational-Dx |
67 consecutive patients, 2 blinded reviewers |
Retrospective, blinded evaluation study to test the following hypotheses: 1) CT enterography findings correlate well with clinical ratings of inflammation (r >0.7); 2) CT enterography detects additional strictures beyond those suspected by clinicians; 3) CT enterography results lead to changes in the clinical likelihood of benefit from steroids; and 4) CT enterography findings correlate (r > 0) with objective laboratory markers of inflammation (erythrocyte sedimentation rate and CRP). |
Individual CT enterography findings correlated poorly (Spearman's rho <0.30) with clinical assessment; clinicians did not suspect 16% of radiologic strictures, and more than half the cases of clinically suspected strictures did not have them on CT enterography; CT enterography data changed clinicians’ perceptions of the likelihood of steroid benefit in 41/67 cases; Specific CT enterography findings correlated with CRP, and a distinct set of CT enterography findings correlated with erythrocyte sedimentation rate in the subset of patients who had these biomarkers measured. CT enterography seems to add unique information to clinical assessment, both in detecting additional strictures and in changing clinicians' perceptions of the likelihood of steroids benefiting patients. The biomarker correlations suggest that CT enterography is measuring real biologic phenomena that correlate with inflammation, providing information distinct from that in a standard clinical assessment. |
2 |
| 32. Elsayes KM, Al-Hawary MM, Jagdish J, Ganesh HS, Platt JF. CT enterography: principles, trends, and interpretation of findings. Radiographics. 30(7):1955-70, 2010 Nov. |
Review/Other-Dx |
N/A |
To discuss the technique of CT enterography and its utility in the evaluation of small bowel diseases. |
CT enterography is particularly useful for differentiating between active and fibrotic bowel strictures in patients with CD, thus enabling selection of the most appropriate treatment (medical management or intervention) for an improved outcome. CT enterography allows excellent visualization of the entire thickness of the bowel wall and depicts extraenteric involvement as well, providing more detailed and comprehensive information about the extent and severity of the disease process. |
4 |
| 33. Baker ME, Walter J, Obuchowski NA, et al. Mural attenuation in normal small bowel and active inflammatory Crohn's disease on CT enterography: location, absolute attenuation, relative attenuation, and the effect of wall thickness. AJR Am J Roentgenol. 2009;192(2):417-423. |
Observational-Dx |
227 CT enterography exams (191 were normal and 36 had active inflammatory CD in the terminal ileum) |
Case-control study. To measure relative and absolute wall attenuations and wall thickness in normal small bowel on contrast-enhanced CT enterography and to study the efficacy of relative attenuation, absolute attenuation, and wall thickness in distinguishing normal from active inflammatory CD of the terminal ileum. |
Relative attenuation and absolute attenuation in the normal distended and collapsed duodenum and left upper quadrant were significantly greater than in all other segments (P<0.001 and <0.048 for relative attenuation and P<0.001 and <0.032 for absolute attenuation, respectively). Relative attenuation and wall thickness models and absolute attenuation and wall thickness models discriminated normal from active terminal ileum CD significantly better than the same measurements without wall thickness (P=0.017 and 0.001, respectively). When the bowel wall is >3 mm, a relative attenuation cutoff of 0.5 is 89% sensitive and 81% specific. In normal small bowel, when wall measurement is taken into account, the duodenum and jejunum have a greater relative attenuation and absolute attenuation than other segments. Relative attenuation and absolute attenuation with wall thickness models discriminate normal from active terminal ileum CD better than the same measurements without wall thickness. |
2 |
| 34. Colombel JF, Solem CA, Sandborn WJ, et al. Quantitative measurement and visual assessment of ileal Crohn's disease activity by computed tomography enterography: correlation with endoscopic severity and C reactive protein. Gut. 55(11):1561-7, 2006 Nov. |
Observational-Dx |
143 patients |
Retrospective study to examine whether small bowel inflammation at CT enterography correlates with endoscopic severity and CRP in CD. |
Quantitative measures of bowel enhancement at CT enterography correlate with endoscopic and histological severity. CRP correlates with radiological finding of perienteric inflammation. |
2 |
| 35. Schmidt S, Guibal A, Meuwly JY, et al. Acute complications of Crohn's disease: comparison of multidetector-row computed tomographic enterography with magnetic resonance enterography. Digestion. 82(4):229-38, 2010. |
Observational-Dx |
57 patients |
To compare MDCT enterography with MR enterography performed upon acute exacerbation of CD. |
MDCT enterography demonstrated fewer artifacts than MR enterography (P<0.0001). In 48 MDCT/MR enterography examinations, active disease was demonstrated: abscesses (n = 11), fistulas (n = 13), stenoses (n = 23) and/or intestinal inflammation (n = 38). Observers' agreement (range 0.56–0.87) was not significantly different between MDCT and MR enterography, neither in terms of sensitivity (range 58%–95%) nor specificity (range 67%–100%) for each of the 8 pathological features. |
2 |
| 36. Vogel J, da Luz Moreira A, Baker M, et al. CT enterography for Crohn's disease: accurate preoperative diagnostic imaging. Dis Colon Rectum. 2007;50(11):1761-1769. |
Observational-Dx |
36 patients |
Retrospective study to correlate CT enterography findings with operative findings in patients with CD. |
In 36 patients, the presence or absence of stricture, fistula, abscess, or inflammatory mass was correctly determined by CT enterography in 100%, 94%, 100%, and 97%, respectively. Accuracy for stricture or fistula number was 83% and 86%, respectively. There were 9 patients with multiple disease phenotypes identified on CT enterography of which 8 were confirmed at surgery. CT enterography overestimated or underestimated the extent of disease in 11 patients (31%). CT enterography is an accurate preoperative diagnostic imaging study for small-bowel CD. The ability of this imaging study to detect both luminal and extraluminal pathology is a distinct advantage of CT enterography compared with small-bowel contrast studies. |
3 |
| 37. Booya F, Akram S, Fletcher JG, et al. CT enterography and fistulizing Crohn's disease: clinical benefit and radiographic findings. Abdominal Imaging. 34(4):467-75, 2009 Jul. |
Review/Other-Dx |
56 patients |
Retrospective study to estimate the clinical benefit of CT enterography in patients with fistulizing CD and describe the appearance of fistulas at CT enterography. |
There was no or remote suspicion of fistula or abscess at pre-imaging clinical assessment in 50% of patients. 34 patients (61%) required a change in or initiation of medical therapy and another 10 (18%) underwent an interventional procedure based on CT enterography findings. Among 37 fistulas with reference standard confirmation, 30 (81%) were extraenteric tracts, and 32 (86%) were hyperenhancing compared to adjacent bowel loops. Most fistulas (68%) contained no internal air or fluid. CT enterography detects clinically occult fistulas and abscesses, resulting in changes in medical management and radiologic or surgical intervention. Most fistulas appear as hyperenhancing, extraenteric tracts, usually without internal air or fluid. |
4 |
| 38. Fidler JL, Fletcher JG, Bruining DH, Trenkner SW. Current status of CT, magnetic resonance, and barium in inflammatory bowel disease. Semin Roentgenol. 2013;48(3):234-244. |
Review/Other-Dx |
N/A |
To explain the clinical benefits and appropriate utilization of cross-sectional enterography, review the technique and performance of CT enterography and MR enterography, and discuss the findings and approaches to interpretation. |
Imaging plays a major role in the evaluation of patients with CD. Cross-sectional techniques provide valuable complementary information that cannot be obtained with endoscopic techniques. Their utilization will likely continue to increase in the future as they are used to monitor new therapies. Barium fluoroscopic studies can provide valuable dynamic information and remain useful for problem solving. |
4 |
| 39. Orel SG, Rubesin SE, Jones B, Fishman EK, Bayless TM, Siegelman SS. Computed tomography vs barium studies in the acutely symptomatic patient with Crohn disease. J Comput Assist Tomogr. 1987;11(6):1009-1016. |
Review/Other-Dx |
43 patients |
To assess the ability of gastrointestinal contrast studies and CT to define the location and extent of CD. |
In 39/43 (91%) patients the contrast studies and CT agreed on the location of active disease. However, in 15/43 (35%) patients, contrast studies demonstrated additional areas of mucosal disease remote from the major area of activity that were not suggested by CT. In addition to demonstrating more extensive mucosal disease, contrast studies proved superior in demonstrating enteroenteric fistulae, sinus tracts, strictures, postsurgical anatomy, and relation of recurrence to anastomosis. CT proved superior in demonstrating mesenteric inflammation, abscesses, enterovesical and enterocutaneous fistulae, fistula to iliopsoas muscle and to sacrum. |
4 |
| 40. Fiorino G, Bonifacio C, Peyrin-Biroulet L, et al. Prospective comparison of computed tomography enterography and magnetic resonance enterography for assessment of disease activity and complications in ileocolonic Crohn's disease. Inflamm Bowel Dis. 2011;17(5):1073-1080. |
Observational-Dx |
44 patients |
To prospectively compare the sensitivity, specificity, and accuracy of abdominal MR enterography and CT enterography to assess disease activity and complications (fistulas, strictures) in ileocolonic CD. |
No significant differences in sensitivity, specificity, and accuracy were observed between MR enterography and CT enterography regarding the following parameters at the patient level: localization of CD (P=1.0), bowel wall thickening (P=1.0), bowel wall enhancement (P=1.0), enteroenteric fistulas (P=0.08), detection of abdominal nodes (P=1.0), and perivisceral fat enhancement (P=0.31). MR was significantly superior compared to CT in detecting strictures (P=0.04). Per segment analysis showed that MR enterography was significantly superior to CT enterography in detecting ileal wall enhancement (P=0.02). |
2 |
| 41. Voderholzer WA, Beinhoelzl J, Rogalla P, et al. Small bowel involvement in Crohn's disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis. Gut. 2005;54(3):369-373. |
Observational-Dx |
41 patients |
To validate the gain in information and therapeutic impact of wireless capsule endoscopy in patients with CD. |
In 15 patients (27%), wireless capsule endoscopy could not be performed due to strictures detected by CT enteroclysis. From the other 41 patients, jejunal or ileal lesions were found in 25 patients by wireless capsule endoscopy compared with 12 by CT enteroclysis (P=0.004). This gain in information was mainly due to detection of small mucosal lesions such as villous denudation, aphthoid ulcerations, or erosions. Both methods were not significantly different in the detection of lesions in the terminal/neoterminal ileum (wireless capsule endoscopy 24 patients, CT enteroclysis 20 patients). Therapy was changed due to wireless capsule endoscopy findings in 10 patients. Consecutively, all of them improved clinically. |
3 |
| 42. Hara AK, Leighton JA, Heigh RI, et al. Crohn disease of the small bowel: preliminary comparison among CT enterography, capsule endoscopy, small-bowel follow-through, and ileoscopy. Radiology. 2006;238(1):128-134. |
Observational-Dx |
17 patients |
To prospectively compare 4 diagnostic small bowel imaging techniques in CD. |
CD was depicted by capsule endoscopy in 12 patients (71%), ileoscopy in 11 (65%), CT enterography in 9 (53%), and SBFT in 4 (24%). Capsule endoscopy and CT enterography may depict CD when ileoscopy and SBFT are negative. |
2 |
| 43. Kohli MD, Maglinte DD. CT enteroclysis in small bowel Crohn's disease. [Review] [29 refs]. Eur J Radiol. 69(3):398-403, 2009 Mar. |
Review/Other-Dx |
N/A |
To describe how we perform CT enteroclysis in the investigation of small bowel Crohn’s disease and discuss the role of CT enteroclysis in the currentmanagement of small bowel Crohn’s disease. |
No results stated in abstract |
4 |
| 44. Maglinte DD.. Fluoroscopic and CT enteroclysis: evidence-based clinical update. [Review]. Radiol Clin North Am. 51(1):149-76, 2013 Jan. |
Review/Other-Dx |
N/A |
To present an update on the current role of double-contrast (DC) barium enteroclysis and Computed tomographic enteroclysis (CTE) modifications in the diagnosis and management of small bowel (SB) diseases from evidence- and experience-based analyses and examines factors why enteral volume-challenged examinations despite their reported higher accuracy and reliability in ruling out SB disease are infrequently performed in clinical practice. |
No results stated in abstract |
4 |
| 45. Minordi LM, Vecchioli A, Guidi L, Mirk P, Fiorentini L, Bonomo L. Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease. Eur Radiol. 2006;16(7):1527-1536. |
Observational-Dx |
52 patients |
Prospective study to determine value of MDCT enteroclysis vs barium enteroclysis with methylcellulose in small bowel disease. |
Sensitivity, specificity and diagnostic accuracy of MDCT enteroclysis vs barium enteroclysis was 83%, 100% and 89%, respectively. CT-E provides good representation of pathological patterns of CD. |
3 |
| 46. Sailer J, Peloschek P, Schober E, et al. Diagnostic value of CT enteroclysis compared with conventional enteroclysis in patients with Crohn's disease. AJR Am J Roentgenol. 2005;185(6):1575-1581. |
Observational-Dx |
50 consecutive patients |
Prospective study to assess the diagnostic value of CT-E compared with conventional enteroclysis in patients with CD. |
CD-associated radiographic changes were found in 44 patients (88%) using CT-E and in 42 patients (84%) using conventional enteroclysis. CT-E proved to be significantly superior to conventional enteroclysis in depicting intramural and extramural CD. |
2 |
| 47. Minordi LM, Vecchioli A, Mirk P, Bonomo L. CT enterography with polyethylene glycol solution vs CT enteroclysis in small bowel disease. Br J Radiol. 84(998):112-9, 2011 Feb. |
Observational-Dx |
145 patients |
To compare CT enterography with polyethylene glycol solution (PEG-CT) with CT enteroclysis (CT-E) in patients with suspected small bowel disease. |
Crohn’s disease was diagnosed in 64 patients, neoplasms in 16, adhesions in 6. Distension of the jejunum was better with CT-E than PEG-CT (p<0.05: statisticallysignificant difference). No significant difference was present for others sites (p>0.05). Evaluation of pathological ileal loops was good with both techniques. The values of sensitivity, specificity and diagnostic accuracy were respectively 94%, 100% and 96% with CT-E, and 93%, 94% and 93% with PEG-CT. The effective dose for PEG-CT was less than the dose for the CT-E (34.7 mSv vs 39.91 mSv). |
2 |
| 48. Masselli G, Gualdi G. MR imaging of the small bowel. [Review]. Radiology. 264(2):333-48, 2012 Aug. |
Review/Other-Dx |
N/A |
To describe how to perform MR imaging examinations and interpret their findings of the small bowel, to compare the use of MR enteroclysis and MR enterography, and to provide specific protocols for different clinical situations. |
No results stated in abstract |
4 |
| 49. Negaard A, Paulsen V, Sandvik L, et al. A prospective randomized comparison between two MRI studies of the small bowel in Crohn's disease, the oral contrast method and MR enteroclysis. Eur Radiol. 17(9):2294-301, 2007 Sep. |
Observational-Dx |
40 patients |
To compare bowel distension and diagnostic properties of magnetic resonance imaging of the small bowel with oral contrast (MRI per OS) with magneticresonance enteroclysis (MRE). |
The diameter of the small bowel was smaller with MRI per OS than with MRE (difference jejunum: 0.55 cm, p<0.001; ileum: 0.35 cm, p<0.001, terminal ileum:0.09 cm, p=0.08). However, CD was diagnosed with high diagnostic accuracy (sensitivity, specificity, positive and negative predictive values: MRI per OS 88%, 89%, 89%, 89%; MRE 88%, 84%, 82%, 89%) and interobserver agreement (MRI per OS k= 0.95; MRE k=1). |
1 |
| 50. Masselli G, Casciani E, Polettini E, Lanciotti S, Bertini L, Gualdi G. Assessment of Crohn's disease in the small bowel: Prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis. Eur Radiol. 2006;16(12):2817-2827. |
Observational-Dx |
66 consecutive patients |
To assess the diagnostic value of ME enteroclysis compared with conventional enteroclysis in patients with CD and to evaluate the diagnostic accuracy of each different MR sequence. |
The sensitivity, specificity and accuracy of ME enteroclysis were 90%–87% and 83% for the depiction of parietal ulcers, 84%–88% and 86% for pseudopolyps, 100%–94% and 96% for mural stenosis, 93%–100% and 94% for fistulae. The number of detected extraluminal findings was significantly higher with ME enteroclysis (P<0.01). The accuracy of fast imaging employing steady-state acquisition sequence was statistically higher in the depiction of wall ulcers and fistulae than that of 3D-fast spoiled gradient echo (P<0.01) and single-shot fast spin-echo (P<0.05) sequences. Contrast-enhanced 3D-fast spoiled gradient echo R was superior for mural stenosis visualization compared to single-shot fast spin-echo (P<0.05) and fast imaging employing steady-state acquisition (P<0.05). |
2 |
| 51. Florie J, Horsthuis K, Hommes DW, et al. Magnetic resonance imaging compared with ileocolonoscopy in evaluating disease severity in Crohn's disease. Clin Gastroenterol Hepatol. 2005;3(12):1221-1228. |
Observational-Dx |
31 patients |
Retrospective, blinded study to assess the value of MRI in measuring disease activity in CD compared to ileocolonoscopy. |
Correlation between severity rated at MRI and Crohn’s Disease Endoscopic Index of Severity (CDEIS) was moderate to strong with r = 0.61 (P<.001) for observer 1 and r = 0.63 (P<.001) for observer 2. Per segment, best correlation was seen in the terminal ileum (r = 0.63; P<.001, for both observers). Wall thickness correlated moderately to strongly with CDEIS (r = 0.57, P<.001 and r = 0.50, P<.001 for observers 1 and 2), whereas enhancement correlated weakly to moderately (r = 0.45, P<.001 and r = 0.42, P<.001). MRI can correctly identify disease severity in CD. |
3 |
| 52. Florie J, Wasser MN, Arts-Cieslik K, Akkerman EM, Siersema PD, Stoker J. Dynamic contrast-enhanced MRI of the bowel wall for assessment of disease activity in Crohn's disease. AJR Am J Roentgenol. 2006;186(5):1384-1392. |
Observational-Dx |
48 patients |
To evaluate the role of MR enterography in predicting disease activity of CD. |
Bowel wall enhancement characteristics and bowel wall thickness correlated with objective measures of disease activity.. |
2 |
| 53. Fidler J. MR imaging of the small bowel. Radiol Clin North Am. 2007; 45(2):317-331. |
Review/Other-Dx |
N/A |
Review MRI of the small bowel with enterography and enteroclysis techniques. Article reviews the advantages, limitations, technique, and indications and the results that have been obtained in evaluating different disease processes. |
Cross-sectional imaging techniques such as CT and MRI have advantages over traditional barium fluoroscopic techniques in their ability to visualize superimposed bowel loops better and to improve visualization of extraluminal findings and complications. |
4 |
| 54. Stoddard PB, Ghazi LJ, Wong-You-Cheong J, Cross RK, Vandermeer FQ. Magnetic resonance enterography: state of the art. Inflamm Bowel Dis. 21(1):229-39, 2015 Jan. |
Review/Other-Dx |
N/A |
1. To review the literature reporting the utility of Magnetic resonance enterography (MRE), present MRE imaging examples within the structure of a radiology-based classification system of findings, which include the following categories: active inflammatory, fibrostenotic, fistulizing/perforating, and reparative or regenerative.2. To discuss important considerations in the clinical context of treatment follow-up, cost-effectiveness, and the American College of Radiology standards for appropriate use. |
No results stated in abstract |
4 |
| 55. Del Vescovo R, Sansoni I, Caviglia R, et al. Dynamic contrast enhanced magnetic resonance imaging of the terminal ileum: differentiation of activity of Crohn's disease. Abdom Imaging. 2008;33(4):417-424. |
Observational-Dx |
16 consecutive patients |
To prospectively investigate a new high resolution MRI technique for dynamic evaluation of the enhancement kinetics of bowel parietal layers and to correlate it with CDAI, CRP, endoscopic activity and histologic features. |
About 9 patients showed a layered enhancement of bowel wall (8 active, 1 inactive), whereas inactive (7 cases) group presented a homogeneous pattern. In active patients, the study found a significant difference in parietal layered enhancement curves (M-SM vs Ms-S, P<0.03) not observed in inactive disease and controls (intra-group analysis). M-SM and Ms-S enhanced curves in clinically active patients were significantly different respect to those of patients with inactive CD (P<0.001) (inter-group analysis). Parietal DCE-MRI pattern well correlated with histologic features (r = 0.8; P<0.001, Spearman test). DCE-MRI can be a useful tool for clinical follow-up and in the treatment strategies in CD patients. |
2 |
| 56. Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, Papamastorakis G, Prassopoulos P, Roussomoustakaki M. Assessment of Crohn's disease activity in the small bowel with MR and conventional enteroclysis: preliminary results. Eur Radiol. 2004;14(6):1017-1024. |
Observational-Dx |
19 consecutive patients |
Conventional enteroclysis and MR enteroclysis correlated with CDAI. Patients had colon endoscopy and both conventional and MR enteroclysis examinations. |
Combination of bowel wall changes seen on conventional and MR enteroclysis can discriminate active from inactive CD. |
3 |
| 57. Lawrance IC, Welman CJ, Shipman P, Murray K. Correlation of MRI-determined small bowel Crohn's disease categories with medical response and surgical pathology. World J Gastroenterol. 2009;15(27):3367-3375. |
Observational-Dx |
55 patients; 2 blinded reviewers |
To determine whether MRI can be used to categorize small bowel CD into groups that correlate with response to medical therapy and surgical pathology. Response to medical therapy was determined prospectively. |
Females and category “2” patients were more likely, and patients with luminal narrowing and hold-up less likely, to respond to medical therapy (P<0.05). 17 patients underwent surgery. The surgical pathological findings of fibrosis and the severity of inflammation correlated with the MRI category in all cases. Findings suggest that small bowel CD can be grouped by the MRI findings and that these groups are associated with patients more likely to respond to continued medical therapy. The MRI categories also correlated with the presence and level of intestinal inflammation and fibrosis on surgical pathology, and may be of prognostic use in the management of CD patients. |
1 |
| 58. Martinez MJ, Ripolles T, Paredes JM, Blanc E, Marti-Bonmati L. Assessment of the extension and the inflammatory activity in Crohn's disease: comparison of ultrasound and MRI. Abdom Imaging. 2009;34(2):141-148. |
Observational-Dx |
30 patients; 119 bowel segments |
Prospective study to: examine the efficacy of MRI and US in the assessment of CD activity in comparison with clinical scoring and biologic tests, compare both techniques in the evaluation of extension and transmural complications. |
About 53/119 (45%) bowel segments showed pathological changes in gold standard tests. US was superior to MRI in the localization of affected bowel segments (sensitivity: US 91%; MRI 83%; intertechniques agreement, kappa: 0.905) and in recognizing transmural complications (sensitivity: US 80%; MRI 72%), although significant differences were not found (P>0.05). A statistically significant correlation between color Doppler flow and MR bowel wall enhancement (segment-by-segment analysis and per patient analysis; P>0.5), and between perienteric changes in both techniques (P>0.5) were found. Wall thickness measured on US was significantly greater in the group of patients with clinical activity (P=0.023) or with clinical-biologic activity (P=0.024). Grades of hyperemia and MR contrast enhancement of patients with clinical-biologic activity was higher than in patients without clinical-biologic activity (P=0.019; P=0.023). Both US and MRI are sensitive to localize the affected bowel segments and to detect transmural complications. A significant correlation between color Doppler flow and bowel wall enhancement on MRI was found. US wall thickness, color Doppler flow, and bowel wall enhancement on MRI are related with clinical or biologic activity. |
2 |
| 59. Oto A, Fan X, Mustafi D, et al. Quantitative analysis of dynamic contrast enhanced MRI for assessment of bowel inflammation in Crohn's disease pilot study. Acad Radiol. 2009;16(10):1223-1230. |
Observational-Dx |
11 patients |
Retrospective study. To evaluate the feasibility of quantitative analysis of DCE-MRI data in the detection of bowel inflammation in patients with CD. |
51 bowel segments (19 with inflammation, 32 normal) were included in the analyses. Inflamed bowel segments had faster K(trans) values, larger v(e) values, increased contrast uptake, larger initial areas under the contrast concentration curve, and steeper initial enhancement slopes than normal bowel segments (P<.05). The areas under the ROC curve for these parameters ranged from 0.70 to 0.86. Results demonstrate that the quantitative analysis of DCE-MRI data is possible for the assessment of bowel inflammation in patients with CD. Future studies need be performed on larger numbers of patients to correlate the severity and type of inflammation with kinetic parameters. |
2 |
| 60. Punwani S, Rodriguez-Justo M, Bainbridge A, et al. Mural inflammation in Crohn disease: location-matched histologic validation of MR imaging features. Radiology. 2009;252(3):712-720. |
Observational-Dx |
18 consecutive patients |
Retrospective study. To validate proposed MRI features of CD activity against a histopathologic reference. |
Acute inflammatory score was positively correlated with mural thickness and mural/ CSF signal intensity ratio on T2–weighted fat-saturated images (P<.001 and P=.003, respectively) but not with mural enhancement at 30 and 70 seconds (P=.50 and P=.73, respectively). Acute inflammatory score was higher with layered mural enhancement (P<.001), a pattern also commonly associated with coexisting fibrostenosis (75%). Mural/CSF signal intensity ratio on T2–weighted fat-saturated images was higher in histologically edematous bowel than in nonedematous bowel (P=.04). There was no correlation between any lymph node characteristic and acute inflammatory score. Increasing mural thickness, high mural signal intensity on T2–weighted fat-saturated images, and a layered pattern of enhancement reflect histologic features of acute small-bowel inflammation in CD. |
3 |
| 61. Rimola J, Rodriguez S, Garcia-Bosch O, et al. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn's disease. Gut. 2009;58(8):1113-1120. |
Observational-Dx |
50 patients with clinically active (n=35) or inactive (n=15) CD |
To determine the accuracy of MR for assessment of disease activity and severity in ileocolonic CD. Ileocolonoscopy used as the reference standard. |
MR index had a high accuracy for the detection of disease activity (area under the ROC curve 0.891, sensitivity 0.81, specificity 0.89) and for the detection of ulcerative lesions (area under the ROC curve 0.978, sensitivity 0.95, specificity 0.91) in the colon and terminal ileum. Accuracy of MR for detecting disease activity and assessing severity brings about the possibility of using MR as an alternative to endoscopy in the evaluation of ileocolonic CD. |
2 |
| 62. Rottgen R, Grandke T, Grieser C, Lehmkuhl L, Hamm B, Ludemann L. Measurement of MRI enhancement kinetics for evaluation of inflammatory activity in Crohn's disease. Clin Imaging. 2010;34(1):29-35. |
Observational-Dx |
26 patients; 2 reviewers |
Retrospective study to investigate the feasibility of determining local inflammatory activity of CD by measurement of bowel wall perfusion kinetics using contrast-enhanced MRI. |
The slope of the contrast enhancement curve significantly correlated with local inflammatory activity determined by endoscopy (R=0.594, P=.007). No significant correlation was found for area under the curve and peak maximum (R=0.411, P=.08 and R=0.334, P=.15, respectively). Determination of the perfusion kinetics of the bowel wall by MRI enables quantitative evaluation of local inflammatory activity in patients with CD. |
3 |
| 63. Rottgen R, Herzog H, Lopez-Haninnen E, Felix R. Bowel wall enhancement in magnetic resonance colonography for assessing activity in Crohn's disease. Clin Imaging. 2006;30(1):27-31. |
Observational-Dx |
42 consecutive patients |
To examine whether there is a correlation between MR colonography and pathological findings in colonoscopy. |
Significant correlation between change of the signal intensity and colonoscopically assessed inflammatory activity. The degree of contrast enhancement of the colonic wall may be a criterion for the degree of enhancement in CD. |
3 |
| 64. Sempere GA, Martinez Sanjuan V, Medina Chulia E, et al. MRI evaluation of inflammatory activity in Crohn's disease. AJR Am J Roentgenol. 2005;184(6):1829-1835. |
Observational-Dx |
20 patients 10 controls 40 MRI studies |
Prospective study to assess the capability of MRI to quantitatively evaluate pathologic changes in CD relapse compared to ileocolonoscopy and histological changes. |
MRI has ability to detect pathologic bowel segments in CD—it allows the measurement of significant variations in wall thickness and contrast enhancement on changing from the active phase of the disease to remission. |
1 |
| 65. Wnorowski AM, Guglielmo FF, Mitchell DG. How to perform and interpret cine MR enterography. [Review]. J Magn Reson Imaging. 42(5):1180-9, 2015 Nov. |
Review/Other-Dx |
N/A |
To outline how to perform and interpret cine MR enterography. |
No results stated in abstract. |
4 |
| 66. Borthne AS, Abdelnoor M, Rugtveit J, Perminow G, Reiseter T, Klow NE. Bowel magnetic resonance imaging of pediatric patients with oral mannitol MRI compared to endoscopy and intestinal ultrasound. Eur Radiol. 2006;16(1):207-214. |
Observational-Dx |
43 patients |
To assess the sensitivity, specificity, and diagnostic accuracy of MRI in pediatric patients with clinical suspicion of IBD by comparing MRI and US to endoscopy, the gold standard. |
A median volume of 300 mL of mannitol in a 4.5% watery solution were ingested by 43 children prior to examination. The 53 MRI examinations were compared with 20 endoscopies and 41 US of the terminal ileum. The outcomes were MRI quality; pathologic findings; level of adverse events; and concordance between endoscopy, MRI, and US estimated by kappa statistics. The ileum and terminal ileum were very good or excellently imaged in approximately 80% of cases. Wall thickening and enhancement were most frequent in the terminal ileum. MRI compared with endoscopy had a sensitivity of 81.8% [95% CI], specificity of 100%, diagnostic accuracy of 90%, and kappa value of 0.80 (95% CI), indicating a good degree of concordance. |
2 |
| 67. Pilleul F, Godefroy C, Yzebe-Beziat D, Dugougeat-Pilleul F, Lachaux A, Valette PJ. Magnetic resonance imaging in Crohn's disease. Gastroenterol Clin Biol. 2005;29(8-9):803-808. |
Observational-Dx |
62 patients |
To evaluate the value of gadolinium enhanced MRI with oral opacification using a 5% mannitol solution (CE-Mannitol-MRI) to reveal bowel inflammation in pediatric patients with known or suspected CD. |
The sensitivity and specificity of CE-Mannitol-MRI for the diagnosis of CD were 83% and 100%, respectively. Bowel wall enhancement was higher in the group of patients with abnormal small bowel loops vs control group (P=0.001). In patients with known CD, there was a positive correlation between wall thickness and PCDAI (P=0.003). However, no significant correlation was demonstrated between parietal contrast enhancement and PCDAI (P=0.497). CE-Mannitol-MRI enabled identification of complications in 18 patients (9 fistulae, 8 strictures and 1 intussusception). |
2 |
| 68. Jensen MD, Kjeldsen J, Rafaelsen SR, Nathan T. Diagnostic accuracies of MR enterography and CT enterography in symptomatic Crohn's disease. Scand J Gastroenterol. 46(12):1449-57, 2011 Dec. |
Observational-Dx |
35 patients |
To determine and compare the sensitivities and specificities of MR enterography and CT enterography for detection of small bowel lesions with emphasis on stenoses in this group of patients. |
A total of 35 patients had active small bowel CD (jejunum 0, ileum 1, (neo)-terminal ileum 34) and 20 had small bowel stenosis. The sensitivity and specificity of MR enterography for detection of small bowel CD was 74% and 80% compared to 83% and 70% with CT enterography (p ‡ 0.5). MR enterography and CT enterography detected small bowel stenosis with 55% and 70% sensitivities, respectively (P=0.3) and 92% specificities. |
1 |
| 69. Tielbeek JA, Ziech ML, Li Z, et al. Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn's disease assessment with histopathology of surgical specimens. Eur Radiol. 24(3):619-29, 2014 Mar. |
Observational-Dx |
20 patients |
To prospectively compare conventional MRI sequences, dynamic contrast enhanced (DCE) MRI and diffusion weighted imaging (DWI) with histopathology of surgical specimens in Crohn’s disease. |
Twenty patients (mean age 38 years, 12 female) were included and 50 sections (35 terminal ileum, 11 ascending colon, 2 transverse colon, 2 descending colon) were matched to AIS and FS. Mural thickness, T1 ratio, T2 ratio, ME and ISI correlated significantly with AIS, with moderate correlation (r=0.634, 0.392, 0.485, 0.509, 0.525, respectively; all P < 0.05). Mural thickness, T1 ratio, T2 ratio, ME, ISI and ADC correlated significantly with FS (all P <0.05). |
2 |
| 70. Jensen MD, Ormstrup T, Vagn-Hansen C, Ostergaard L, Rafaelsen SR. Interobserver and intermodality agreement for detection of small bowel Crohn's disease with MR enterography and CT enterography. Inflamm Bowel Dis. 17(5):1081-8, 2011 May. |
Observational-Dx |
50 patients |
To determine the interobserver and intermodality agreement for detection of small bowel CD. |
The image quality was better with CT enterography than MR enterography (P<0.001) but the diagnostic yields were comparable (P=0.4). For detection of small bowel CD, the interobserver agreement was substantial in CT enterography (kappa = 0.64) and moderate in MR enterography (kappa = 0.48). The intermodality agreement was fair to substantial (kappa = 0.40–0.64) for different observers. 2 abscesses were detected and confirmed at subsequent surgery. 1 abscess was not detected with MR enterography and only recorded by 2 observers in CT enterography. A total of 10 fistulas were detected: 3 were confirmed at subsequent surgery and 4 were false-positive findings. |
2 |
| 71. Schmidt S, Lepori D, Meuwly JY, et al. Prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis: interobserver agreement and sensitivity by means of "sign-by-sign" correlation. Eur Radiol. 2003;13(6):1303-1311. |
Observational-Dx |
50 patients |
A prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis. |
Sensitivities and specificities resulted from comparison with pathological results (n=29) and patient's clinical evolution (n=21). Most pathological signs, such as bowel wall thickening, bowel wall enhancement and lymphadenopathy, showed better interobserver agreement on multidetector spiral-CT enteroclysis than on MR enteroclysis (bowel wall thickening: 0.65 vs 0.48; bowel wall enhancement: 0.51 vs 0.37; lymphadenopathy: 0.52 vs 0.15). Sensitivity of multidetector spiral-CT enteroclysis was higher than that of MR enteroclysis in detecting bowel wall thickening (88.9% vs 60%), bowel wall enhancement (78.6% vs 55.5%) and lymphadenopathy (63.8% vs 14.3%). Wilcoxon signed-rank test revealed significantly better sensitivity of multidetector spiral-CT enteroclysis than that of MR enteroclysis for each observer (P=0.028, P=0.046, P=0.028, respectively). |
2 |
| 72. Siddiki HA, Fidler JL, Fletcher JG, et al. Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn's disease. AJR Am J Roentgenol. 2009;193(1):113-121. |
Observational-Dx |
33 patients, 4 independent reviewers: 2 for MR enterography 2 for CT enterography |
Blinded prospective study. To obtain pilot data on the accuracy of MR enterography for detecting small-bowel CD compared with CT enterography and with a clinical reference standard based on imaging, clinical information, and ileocolonoscopy. |
All 33 patients underwent CT enterography and ileocolonoscopy, 30 of whom also underwent MR enterography. Sensitivities of MR enterography and CT enterography for detecting active small-bowel CD were similar (90.5% vs 95.2%, respectively; P=0.32). The image quality scores for MR enterography examinations were significantly lower than those for CT enterography (P=0.005). MR enterography and CT enterography identified 8 cases (24%) with a final diagnosis of active small-bowel inflammation in which the ileal mucosa appeared normal at ileocolonoscopy. Furthermore, enterography provided the only available imaging in 3 additional patients who did not have ileal intubation. MR enterography and CT enterography have similar sensitivities for detecting active small-bowel inflammation, but image quality across the study cohort was better with CT. Cross-sectional enterography provides complementary information to ileocolonoscopy. |
2 |
| 73. Jesuratnam-Nielsen K, Logager VB, Rezanavaz-Gheshlagh B, Munkholm P, Thomsen HS. Plain magnetic resonance imaging as an alternative in evaluating inflammation and bowel damage in inflammatory bowel disease--a prospective comparison with conventional magnetic resonance follow-through. Scand J Gastroenterol. 50(5):519-27, 2015 May. |
Observational-Dx |
100 patients |
To compare prospectively the diagnostic accuracy of magnetic resonance imaging (MRI) without use of contrast medium orally or intravenously (plain MRI) with magnetic resonance follow-through (MRFT) in patients with inflammatory bowel disease (IBD) |
A total of 100 patients (40 males and 60 females; median age: 38.5; range: 19–90) were enrolled; 44 withCrohn’s disease (CD), 25 with ulcerative colitis (UC), 24 with IBD unclassified (IBD-U), and 7 had other diagnosis.Sensitivity, specificity, and accuracy in CD ranged 50–86%, 93–94%, and 91–92% for wall thickening and 49–82%, 85–93%,and 84–89% for DWI, respectively. Sensitivity, specificity, and accuracy in UC range 0–40%, 87–100%, and 80–100% for wallthickening and 0–52%, 83–94% and 76–92% for DWI, respectively. The k values for bowel wall thickening, DWI, and muralhyperenhancement were detected with fair agreement (k = 0.26–0.39) at both MRI examinations, whereas only bowel wallthickening in MRFT were detected with moderate agreement (k = 0.47) |
2 |
| 74. Bell SJ, Halligan S, Windsor AC, Williams AB, Wiesel P, Kamm MA. Response of fistulating Crohn's disease to infliximab treatment assessed by magnetic resonance imaging. Alimentary Pharmacology & Therapeutics. 17(3):387-93, 2003 Feb. |
Review/Other-Dx |
12 patients |
To assess Crohn’s fistula healing after infliximab treatment using MRI. MRI and clinical evaluation were performed before and after 3 infliximab infusions given over a 6-week period. |
Pretreatment MRI detected abscesses in 3 (2 not treated) of 12 patients. MRI can identify clinically silent sepsis and fistulas may persist despite clinical remission. |
4 |
| 75. Horsthuis K, Lavini C, Bipat S, Stokkers PC, Stoker J. Perianal Crohn disease: evaluation of dynamic contrast-enhanced MR imaging as an indicator of disease activity. Radiology. 2009;251(2):380-387. |
Observational-Dx |
33 patients |
To prospectively determine clinical value of DCE-MRI in the evaluation of disease activity in perianal CD. |
Significant correlations were found between the absolute amounts of the time-intensity curves shape types and Perianal Disease Activity Index (PDAI) and between ROI volume and PDAI. The ratio of quickly enhancing vs slowly enhancing pixels correlated with higher MRI scores as did the ROI volume. The absolute amounts of pixels displaying time-intensity curves types 2, 3, 4, and 5 correlated significantly with MRI score. CRP level showed a significant correlation with mean maximum enhancement. Larger numbers of quickly enhancing pixels were observed in patients who needed medication changes or developed new abscesses during follow-up. DCE-MRI can help determine disease activity in perianal CD and might be helpful in selecting a subpopulation of patients who should be monitored more closely for development of more extensive disease. |
3 |
| 76. Ng SC, Plamondon S, Gupta A, et al. Prospective evaluation of anti-tumor necrosis factor therapy guided by magnetic resonance imaging for Crohn's perineal fistulas. American Journal of Gastroenterology. 104(12):2973-86, 2009 Dec. |
Review/Other-Dx |
34 consecutive patients |
To prospectively evaluate anti-tumor necrosis factor therapy guided by MRI for Crohn’s perineal fistulas. |
34 consecutive patients with perineal fistulas were treated with infliximab (19), adalimumab (7; all infliximab failures) and thalidomide (8). Median follow-up was 110 weeks (range, 74–161). Baseline MRI: 38% =2 tracks, 21% anolabial/rectovaginal. At latest follow-up, clinical fistula ‘response’ and ‘closure’ were seen in 50% and 46% of antibody-treated patients, respectively. All patients stopped thalidomide early due to side effects. Of 26 antibody-treated patients, at 6 (n=25), 12 (n=25), and 18 (n=20) months, respectively, MRI showed complete healing (20%, 28%, and 30%, respectively), improvement (68%, 72%, and 65%), no change (12%, 0%, and 0%) or worsening (0%, 0%, and 5%). MRI healing at 6 months (n=5) persisted at 12 and 18 months, including in 2 patients who stopped treatment at 6 months. Fistula history length and complexity did not influence the outcome. The only surgical intervention was set on insertion in 1 patient. The PDAI and CDAI scores decreased and quality of life improved significantly at last follow-up. MRI fistula resolution was variable and slower than clinical healing. Prolonged treatment is often required for internal track resolution. |
4 |
| 77. Park SH.. DWI at MR Enterography for Evaluating Bowel Inflammation in Crohn Disease. [Review]. AJR Am J Roentgenol. 207(1):40-8, 2016 Jul. |
Review/Other-Dx |
N/A |
To provide a comprehensive review regarding DWI enterography used for evaluating Crohn disease and to summarize the relevant evidence. |
No results stated in abstract. |
4 |
| 78. Choi SH, Kim KW, Lee JY, Kim KJ, Park SH. Diffusion-weighted Magnetic Resonance Enterography for Evaluating Bowel Inflammation in Crohn's Disease: A Systematic Review and Meta-analysis. [Review]. Inflamm Bowel Dis. 22(3):669-79, 2016 Mar. |
Meta-analysis |
159 studies |
To systematically determine the performance of diffusion-weighted imaging magnetic resonance enterography (DWI-MRE) for evaluating bowel inflammation in Crohn's disease and sources of heterogeneity between reported results. |
Of 159 articles screened, we found 12 studies (1515 bowel segments) reporting a diagnosis of bowel inflammation and 6 studies (1066 bowel segments) reporting assessment of inflammatory severity. The summary sensitivity and specificity were 92.9% (95% CI, 85.8%-96.6%; I = 87.9%) and 91% (95% CI, 79.7%-96.3%; I = 95.1%), respectively. Sensitivity and false-positive rate were inversely correlated (r = -0.650; P = 0.022). Lack of blinding to contrast-enhanced MRE when interpreting DWI-MRE (P = 0.01) and use of contrast-enhanced MRE as a reference standard (P < 0.01) in some studies were significant factors for study heterogeneity and likely caused overestimation of DWI-MRE accuracy. There was rather clear correlation between diffusion-related parameters and bowel inflammation severity, although the strengths were heterogeneous (correlation coefficient, 0.39-0.98). |
Good |
| 79. Solem CA, Loftus EV, Jr., Fletcher JG, et al. Small-bowel imaging in Crohn's disease: a prospective, blinded, 4-way comparison trial. Gastrointest Endosc. 2008;68(2):255-266. |
Observational-Dx |
41 patients |
To assess the sensitivity and specificity of capsule endoscopy, CT enterography, ileocolonoscopy, and SBFT in the diagnosis of small bowel CD. |
41 CT enterography examinations were performed. 7 patients (17%) had an asymptomatic partial small-bowel obstruction. 40 patients underwent colonoscopy, 38 had SBFT studies, and 28 had capsule endoscopy examinations. Small-bowel CD was active in 51%, absent in 42%, inactive in 5%, and suspicious in 2% of patients. The sensitivity of capsule endoscopy for detecting active small-bowel CD was 83%, not significantly higher than CT enterography (83%), ileocolonoscopy (74%), or SBFT (65%). However, the specificity of capsule endoscopy (53%) was significantly lower than the other tests (P<.05). 1 patient developed a transient partial small-bowel obstruction due to capsule endoscopy, but no patients had retained capsules. |
1 |
| 80. Maconi G, Sampietro GM, Parente F, et al. Contrast radiology, computed tomography and ultrasonography in detecting internal fistulas and intra-abdominal abscesses in Crohn's disease: a prospective comparative study. Am J Gastroenterol. 2003;98(7):1545-1555 |
Observational-Dx |
128 patients |
To compare US and contrast radiography in detecting intestinal fistulae and abscesses complicating CD. |
Internal fistulae and intra-abdominal abscesses were identified intraoperatively in 56 (43.7%) and 26 (20.3%) patients, respectively. Diagnostic accuracy of US and radiography studies in detecting internal fistulae was comparable (85.2% vs 84.8%), with sensitivity of 71.4% for US and 69.6% for radiography studies, and specificity of 95.8% for both. Combination of radiographic techniques and US significantly improved diagnostic accuracy in detection of internal fistulae. In severe cases of CD with clinical suspicion of septic complications such as abdominal mass or fever, the accuracy of US, barium studies, and CT was 88.5%, 80.3%, and 77%, respectively (P=NS). The presence of abscesses was correctly detected in 90.9% of cases by means of US and in 86.4% by CT (P=NS), although accuracy was higher for CT (91.8%) than for US (86.9%) because of false positive results in US studies. |
2 |
| 81. Triester SL, Leighton JA, Leontiadis GI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn's disease. Am J Gastroenterol. 2006;101(5):954-964. |
Meta-analysis |
9 studies |
To evaluate the yield of capsule endoscopy compared with other modalities in symptomatic patients with suspected or established CD using meta-analysis. |
9 studies (n = 250) compared the yield of capsule endoscopy with small bowel barium radiography for the diagnosis of CD. The yield for capsule endoscopy vs barium radiography for all patients was 63% and 23%, respectively (incremental yield = 40%, P<0.001, 95% CI = 28%–51%). 4 trials compared the yield of capsule endoscopy to colonoscopy with ileoscopy (n = 114). The yield for capsule endoscopy vs ileoscopy for all patients was 61% and 46%, respectively (incremental yield = 15%, P=0.02, 95% CI = 2%–27%). 3 studies compared the yield of capsule endoscopy to CT enterography/CT-E (n = 93). The yield for capsule endoscopy vs CT for all patients was 69% and 30%, respectively (incremental yield = 38%, P=0.001, 95% CI = 15–60%). 2 trials compared capsule endoscopy to push enteroscopy (incremental yield = 38%, P<0.001, 95% CI = 26%–50%) and 1 trial compared capsule endoscopy to small bowel MRI (incremental yield = 22%, P=0.16, 95% CI =-9% to 53%). Subanalysis of patients with a suspected initial presentation of CD showed no statistically significant difference between the yield of capsule endoscopy and barium radiography (P= 0.09), colonoscopy with ileoscopy (P=0.48), CT enterography (P=0.07), or push enteroscopy (P= 0.51). Subanalysis of patients with established CD with suspected small bowel recurrence revealed a statistically significant difference in yield in favor of capsule endoscopy compared with all other modalities (barium radiography (P<0.001), colonoscopy with ileoscopy (P=0.002), CT enterography (P<0.001), and push enteroscopy (P<0.001)). |
M |
| 82. Bernstein CN, Greenberg H, Boult I, Chubey S, Leblanc C, Ryner L. A prospective comparison study of MRI versus small bowel follow-through in recurrent Crohn's disease. Am J Gastroenterol. 2005;100(11):2493-2502. |
Review/Other-Dx |
30 patients |
Prospective study. MR enterography compared to SBFT in established CD to detect complications and assess extent of disease. |
MRI is superior to SBFT in evaluating CD complications and extent of disease. |
4 |
| 83. Albert JG, Martiny F, Krummenerl A, et al. Diagnosis of small bowel Crohn's disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut. 2005;54(12):1721-1727. |
Observational-Dx |
52 consecutive patients |
Prospective study to compare capsule endoscopy, MR enterography and fluoroscopic enteroclysis in suspected and established CD. |
Small bowel CD was diagnosed in 41/52 patients (79%). Capsule endoscopy was slightly more sensitive than MRI (12 vs 10 of 13 in suspected CD and 13 vs 11 of 14 in established CD). MR and capsule endoscopy are complimentary tools for diagnosing CD. |
3 |
| 84. Dong J, Wang H, Zhao J, et al. Ultrasound as a diagnostic tool in detecting active Crohn's disease: a meta-analysis of prospective studies. [Review]. Eur Radiol. 24(1):26-33, 2014 Jan. |
Meta-analysis |
15 studies involving 1558 patients |
To evaluate the diagnostic accuracy of ultrasound in assessing active Crohn’s disease (CD) in adults. |
Fifteen studies involving 1,558 patients were included in this meta-analysis. Overall, the pooled sensitivity (0.88) and LR- (0.14) were not heterogeneous, whereas the pooled specificity (0.97, I2=72.9 %) and LR+(15.10, I2=71.8 %) were. The DOR of ultrasound for assessing active CD was 121.70, with significant heterogeneity (I2=63.3 %). A symmetrical summary ROC curve was plotted showing that the area under the curve was 0.94, indicating good diagnostic accuracy. Meta-regression and subgroup analysis showed that the disease location may be a major cause of heterogeneity. |
Good |
| 85. Zhu C, Ma X, Xue L, et al. Small intestine contrast ultrasonography for the detection and assessment of Crohn disease: A meta-analysis. [Review]. Medicine (Baltimore). 95(31):e4235, 2016 Aug. |
Meta-analysis |
13 articles |
To evaluate the diagnostic accuracy of Small intestine contrast ultrasonography (SICUS) in the detection and assessment of small-bowel lesions and complications in Crohn disease (CD). |
Thirteen articles were finally considered eligible. The pooled sensitivity and specificity of SICUS in detecting small-bowel lesions were 0.883 (95% confidence interval (CI) 0.847–0.913) and 0.861 (95% CI 0.828–0.890), respectively. The pooled diagnostic odds ratio was 39.123 (95% CI 20.014–76.476) and the area under the curve of summary receiver operating characteristic was 0.9273 (standard error: 0.0152). In subgroup analyses, SICUS represented fine sensitivity and specificity in proximal and distal small intestine lesion, as well as in CD-related complications such as stricture, dilation, abscess, and fistula. |
Good |
| 86. Fraquelli M, Colli A, Casazza G, et al. Role of US in detection of Crohn disease: meta-analysis. Radiology. 2005;236(1):95-101. |
Meta-analysis |
N/A |
To evaluate the accuracy of US in the detection of CD in adults by systematically reviewing both cohort studies (those including patients whose clinical characteristics were consistent with those caused by an IBD) and case-control studies (those in which patients with CD were compared with patients with other bowel diseases or healthy control subjects). |
The ranges of US sensitivity and specificity for the diagnosis of CD reported for the included series were 75%–94% and 67%–100%, respectively; the heterogeneity of these values prevented the calculation of a cumulative value. The summary ROC curve revealed a clear cutoff effect that depended on the chosen bowel wall thickness threshold. Sensitivity and specificity of 88% and 93%, respectively, were achieved when a bowel wall thickness threshold >3 mm was used, and sensitivity and specificity of 75% and 97%, respectively, were achieved when a threshold >4 mm was used. |
M |
| 87. Parente F, Greco S, Molteni M, et al. Role of early ultrasound in detecting inflammatory intestinal disorders and identifying their anatomical location within the bowel. Aliment Pharmacol Ther. 2003;18(10):1009-1016. |
Observational-Dx |
487 patients |
To investigate the accuracy of bowel US compared with barium X-ray studies, CT, endoscopy and bowel surgery in the initial assessment of inflammatory bowel disorders. |
336 patients had pathological findings of the bowel detectable at US as the final diagnosis. The main organic disorders found were CD (56%), ulcerative/indeterminate colitis (30%), bowel tumors (5%), appendicitis/diverticulitis (2%) and other inflammatory conditions (8%). The overall sensitivity and specificity of bowel US were 85% and 95%, respectively, whereas the PPV and NPV were 98% and 75%, respectively. Comparisons of US with X-ray or endoscopic results by disease localization showed that the diagnostic performance of US was higher for inflammatory conditions of the ileum and sigmoid/descending colon (sensitivity of 92% and 87%, respectively), whereas abnormalities localized in the rectum, duodenum and proximal jejunum were often missed by US. |
2 |
| 88. Calabrese E, Petruzziello C, Onali S, et al. Severity of postoperative recurrence in Crohn's disease: correlation between endoscopic and sonographic findings. Inflamm Bowel Dis. 2009;15(11):1635-1642. |
Experimental-Dx |
72 patients: 2 independent investigators |
To examine the accuracy of small intestine contrast US in assessing CD recurrence after ileocolonic resection when using ileocolonoscopy as a gold standard. The correlation between the bowel wall thickness measured by small intestine contrast US and the endoscopic score of recurrence was also assessed. Patients were prospectively enrolled. |
Ileocolonoscopy detected recurrence in 67/72 (93%) patients. Small intestine contrast US detected findings compatible with recurrence in 62/72 (86%) patients (5 false negative, 4 false positive, 1 true negative, 62 true positive), showing a 92.5% sensitivity, 20% specificity, and 87.5% accuracy for detecting CD recurrence. The median bowel wall thickness, the extent of the ileal lesions, and the prestenotic dilation were higher in patients with an endoscopic degree of recurrence =3 vs =2 (P<0.001) and the lumen diameter was lower in patients with a Rutgeerts’ score =3 vs =2 (P<0.0001). Although small intestine contrast US and ileocolonoscopy provide different views of the small bowel, small intestine contrast US shows a significant correlation with the endoscopic findings. Small intestine contrast US may represent an alternative noninvasive technique for assessing CD recurrence after ileocolonic resection. |
1 |
| 89. Novak KL, Wilson SR. The role of ultrasound in the evaluation of inflammatory bowel disease. Semin Roentgenol. 2013;48(3):224-233. |
Review/Other-Dx |
N/A |
To review the role of US in the evaluation of IBD. |
No results stated in abstract. |
4 |
| 90. Rodgers PM, Verma R. Transabdominal ultrasound for bowel evaluation. [Review]. Radiol Clin North Am. 51(1):133-48, 2013 Jan. |
Review/Other-Dx |
N/A |
To review US bowel evaluation including imaging for suspected acute appendicitis and acute diverticulitis, as well as the role of US in a multimodality approach for the diagnosis and management of IBD and associated complications. |
No results stated in abstract. |
4 |
| 91. Rigazio C, Ercole E, Laudi C, et al. Abdominal bowel ultrasound can predict the risk of surgery in Crohn's disease: proposal of an ultrasonographic score. Scand J Gastroenterol. 2009;44(5):585-593. |
Observational-Dx |
147 total patients: 49 cases operated on within 30 days after US and 98 matched nonoperated controls |
To evaluate the prognostic role of bowel-wall US morphology on the short-term risk of surgery. |
Wall thickness and US patterns were significantly different between cases and controls (P<0.0001). A wall thickness >4.5 mm was observed in 45/49 cases and 47/98 controls (OR = 12.21), while “disrupted stratification” was observed in 34/49 cases and 12/98 controls (OR = 16.24). Among the clinical and US characteristics recorded only 4 US variables were independently associated with surgery (pattern, thickness, presence of fistulae/abscesses and stenoses) and considered for the US score=(2.5*US pattern)+(1.5*Bowel thickness)+(3*Presence of fistulae/abscesses)+(1.5*Presence of stenoses). Based on this score, up to 84% of patients were correctly classified according to actual status (operated/nonoperated). Proposed score seems to be a reliable prognostic marker for the short-term risk of surgery in CD. Further prospective validation needed. |
3 |
| 92. Ripolles T, Martinez MJ, Barrachina MM. Crohn's disease and color Doppler sonography: response to treatment and its relationship with long-term prognosis. J Clin Ultrasound. 2008;36(5):267-272 |
Observational-Dx |
28 patients |
Prospective study to evaluate the ability of US to detect changes in patients undergoing treatment for CD and whether these findings are related to the patient’s long-term outcome. |
Initial baseline US revealed at least 1 thickened segment of the bowel wall in all of the patients. In this initial examination, 18/22 patients (81%) with clinically active disease had moderate or marked parietal vascularity. A statistically significant reduction in the vascularity of the affected bowel was observed on the third US examination (P<0.05). 17 patients who were in clinical remission had relapse and were treated with immunosuppressive therapy or surgery during the follow-up. 86% of the patients with residual hyperemia on US examination after treatment had an unfavorable clinical course compared with only 30% of the patients with no, or barely visible, residual hyperemia (P<0.01). US can identify bowel inflammation and its changes during treatment. |
2 |
| 93. Ripolles T, Rausell N, Paredes JM, Grau E, Martinez MJ, Vizuete J. Effectiveness of contrast-enhanced ultrasound for characterisation of intestinal inflammation in Crohn's disease: a comparison with surgical histopathology analysis. J Crohns Colitis. 7(2):120-8, 2013 Mar. |
Observational-Dx |
25 patients |
To evaluate the accuracy of several US parameters, especially of contrast-enhanced US, for evaluation of mural inflammation in Crohn's disease (CD), with histopathology as the reference. |
28 segments were analysed. In pathology analysis there were 12 predominantly inflammatory segments, 9 predominantly fibrostenotic and 7 compound lesions. When the pathology score was dichotomised into two groups (inflammatory and fibrostenotic) the number of stenoses correctly classified by US was 23 out 28, with a substantial agreement (kappa=0.632). There was a good correlation between the sonographic and pathology scores, both inflammation (Spearman's, r=0.53) and fibrostenosis (Spearman's, r=0.50). Transmural complications, colour Doppler grade and percentage of increase in contrast enhancement were significantly associated with the pathology inflammatory score (p=0.018, p=0.036 and p=0.005, respectively). There was a significantly negative association between the colour Doppler grade and the pathologic fibrostenotic score. |
3 |
| 94. Sasaki T, Kunisaki R, Kinoshita H, et al. Use of color Doppler ultrasonography for evaluating vascularity of small intestinal lesions in Crohn's disease: correlation with endoscopic and surgical macroscopic findings. Scand J Gastroenterol. 49(3):295-301, 2014 Mar. |
Observational-Dx |
108 patients |
To evaluate the vascularity of small intestinal lesions in Crohn’s disease using color Doppler US (CD-US) and retrospectively compare them with endoscopic and surgical macroscopic findings. |
A substantial positive correlation was observed between Limberg scores and SES-CD (r = 0.709 [p < 0.001]). Notably, all 27 cases with a Limberg score of 3 or 4 were classified as endoscopically active. Compared to surgical macroscopic activity, Limberg scores of active lesions were significantly higher than those of non-active lesions (p = 0.005). In particular, all 11 cases with a Limberg score of 3 or 4 were classified as active lesions. |
3 |
| 95. Nylund K, Jirik R, Mezl M, et al. Quantitative contrast-enhanced ultrasound comparison between inflammatory and fibrotic lesions in patients with Crohn's disease. Ultrasound Med Biol. 39(7):1197-206, 2013 Jul. |
Observational-Dx |
Eighteen patients with fibrotic disease and 19 patients with inflammation, 30 healthy subjects in control group |
To determine whether there are differences in absolute blood flow between patients with Crohn’s disease with inflammation or fibrosis using contrast-enhanced ultrasound. |
Feasibility of the examination was 89%. The fibrosis group had lower blood volume (0.9 vs. 3.4 mL per 100 mL tissue; p = 0.001) and flow (22.6 vs. 45.3 mL/min per 100 mL tissue; p = 0.003) compared with the inflammation group. There was no significant difference in mean transit time (3.9 vs. 5.5 s). |
3 |
| 96. Maconi G, Ardizzone S, Greco S, Radice E, Bezzio C, Bianchi Porro G. Transperineal ultrasound in the detection of perianal and rectovaginal fistulae in Crohn's disease. Am J Gastroenterol. 2007;102(10):2214-2219. |
Observational-Dx |
46 patients |
Prospective study to examine CD perianal and rectovaginal fistulae using transperineal US and compare the findings with results of endoanal US as reference standard. |
52 fistulae (3 intra-sphincteric, 28 transsphincteric, 8 suprasphincteric, 2 extrasphincteric, 9 rectovaginal, and 2 anovulvar) were detected by transperineal US. Endoanal US confirmed the correct classification of 45 fistulae (PPV: 86.5%). Of the 53 fistulae detected by endoanal US, 45 were correctly classified by transperineal US (sensitivity 84.9%). Transperineal US showed 10 perianal abscesses: 2 horseshoe, 4 deep, and 4 superficial. Endoanal US confirmed all horseshoe, 3 deep, and 2 superficial abscesses and did not find further abscesses. Transperineal US is a simple, painless, real-time method to detect and classify perianal and rectovaginal fistulae and/or abscesses in CD. |
1 |
| 97. Panes J, Bouzas R, Chaparro M, et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn's disease. Aliment Pharmacol Ther. 2011;34(2):125-145. |
Review/Other-Dx |
68 publications |
To perform an assessment of the diagnostic accuracy of cross-sectional imaging techniques for diagnosis of CD, evaluation of disease extension and activity and diagnosis of complications, and to provide recommendations for their optimal use. |
US is an accurate technique for diagnosis of suspected CD and for evaluation of disease activity (sensitivity 0.84, specificity 0.92), is widely available and noninvasive, but its accuracy is lower for disease proximal to the terminal ileum. MRI has a high diagnostic accuracy for the diagnosis of suspected CD and for evaluation of disease extension and activity (sensitivity 0.93, specificity 0.90), and is less dependent on the examiner and disease location compared with US. CT has a similar accuracy to MRI for assessment of disease extension and activity. The 3 techniques have a high accuracy for identification of fistulas, abscesses and stenosis (sensitivities and specificities >0.80), although US has false positive results for abscesses. As a result of the lack of radiation, US or MRI should be preferred over CT, particularly in young patients. |
4 |
| 98. Stathaki MI, Koukouraki SI, Karkavitsas NS, Koutroubakis IE. Role of scintigraphy in inflammatory bowel disease. World J Gastroenterol. 2009;15(22):2693-2700. |
Review/Other-Dx |
N/A |
To review the current data and future prospects on the role of scintigraphy in diagnosis and evaluation of disease activity in patients with IBD. |
Although nuclear medicine in IBD has no primary role in the diagnosis, it might be considered when colonoscopy is not completed successfully or other imaging modalities are negative. However, its contribution to the assessment of disease extent and activity, monitoring treatment response, and differentiating between active CD and UC is well established. Tc-99m HMPAO WBC have gain widespread clinical use while Tc-99m (V) DMSA seems to provide an accurate scintigraphic variant and a complementary technique to colonoscopy for follow up and assessment of disease activity. |
4 |
| 99. Annovazzi A, Bagni B, Burroni L, D'Alessandria C, Signore A. Nuclear medicine imaging of inflammatory/infective disorders of the abdomen. [Review] [124 refs]. Nucl Med Commun. 26(7):657-64, 2005 Jul. |
Meta-analysis |
Inflammatory bowel disease: 49 papers, Appendicitis: 24 papers and Vascular graft infections: 37 papers |
A meta-analysis to describe the use of nuclear medicine imaging for the study of inflammatory bowel disorders, appendicitis and vascular graft infections |
No results stated in abstract |
Inadequate |
| 100. Saboury B, Salavati A, Brothers A, et al. FDG PET/CT in Crohn's disease: correlation of quantitative FDG PET/CT parameters with clinical and endoscopic surrogate markers of disease activity. Eur J Nucl Med Mol Imaging. 41(4):605-14, 2014 Apr. |
Observational-Dx |
22 subjects |
To determine the feasibility and potential clinical utility of assessment of Crohn’s disease (CD) activity by 18F-fluorodeoxyglucose (FDG) positronemission tomography (PET)/CT employing a new quantitative approach. |
SUVmax, PVC-SUVmean, and PVC-TLG significantly correlated with segment CDEIS subscores (r =0.50, r =0.69, and r =0.31, respectively; p <0.05). GCDAS significantly correlated with CDAI and fecal calprotectin (r =0.64 and r = 0.51, respectively; p <0.05). |
2 |
| 101. Catalano OA, Gee MS, Nicolai E, et al. Evaluation of Quantitative PET/MR Enterography Biomarkers for Discrimination of Inflammatory Strictures from Fibrotic Strictures in Crohn Disease. Radiology. 278(3):792-800, 2016 Mar. |
Observational-Dx |
19 patients |
To retrospectively evaluate positron emission tomography (PET)/magnetic resonance (MR) enterography for the differentiation of fibrotic strictures from inflammatory strictures in patients with Crohn disease. |
Three of the PET/MR enterography biomarkers, SUVmax, SI on T2-weighted images * SUVmax, and ADC * SUVmax, showed significant differences in the fibrosis group compared with the fibrosis with active inflammation group and the active inflammation only group. The best discriminator between fibrosis and active inflammation was the combined PET/MR enterography biomarker ADC * SUVmax cutoff of less than 3000, which was associated with accuracy, sensitivity, and specificity values of 0.71, 0.67, and 0.73, respectively. |
2 |
| 102. Bettenworth D, Reuter S, Hermann S, et al. Translational 18F-FDG PET/CT imaging to monitor lesion activity in intestinal inflammation. J Nucl Med. 54(5):748-55, 2013 May. |
Observational-Dx |
25 patients with Crohn colitis and C57BL/6 wild-type (WT) female mice |
To evaluate the translational potential of noninvasive 18F-FDG PET/ CT for the assessment of mucosal damage in murine dextran sodium sulfate (DSS) colitis and human inflammatory bowel disease (IBD). |
At days 4 and 7 after DSS induction, colonic 18F-FDG uptake was significantly increased, with a distinct peak in the medial colon. 18F-FDG uptake strongly correlated with histologic epithelial damage. Additionally, 18F-FDG uptake increased in the bone marrow in the course of the disease, correlating with anincrease in intestinal 18F-FDG uptake. Histology and fluorescence- activated cell sorting analysis of the bone marrow of DSS mice revealed an increased number of immature neutrophils, whereas mucosal polymerase chain reaction suggested a correlation of 18F-FDG uptake to T cell infiltration. In accordance with the results of 18F-FDG PET/CT in DSS colitis, an increased 18F-FDG uptake was found in 87% of deep mucosal ulcerations in IBD patients, whereas mild endoscopic lesions were detected only by 18F-FDG PET/CT in about 50% of patients assessed. |
3 |
| 103. Zhang J, Li LF, Zhu YJ, et al. Diagnostic performance of 18F-FDG-PET versus scintigraphy in patients with inflammatory bowel disease: a meta-analysis of prospective literature. Nucl Med Commun. 35(12):1233-46, 2014 Dec. |
Meta-analysis |
20 studies |
To evaluate the diagnostic performance of fluorine-18 fluorodeoxyglucose- PET (18F-FDG-PET), leukocyte scintigraphy (LS), and monoclonal antigranulocyte antibody scintigraphy (MAAS) in patients with inflammatory bowel disease (IBD) and perform pairwise comparisons of the diagnostic accuracy between these different imaging modalities. |
Twenty prospective studies were reviewed. On per-bowel-segment basis, the 18F-FDG-PET had a pooled sensitivity of 0.84, specificity of 0.86, AUC of 0.913, and Q* index of 0.845, whereas for LS, the corresponding values were 0.79, 0.86, 0.877, and 0.808, respectively, and for MAAS they were 0.45, 0.94, 0.524, and 0.518, respectively. On per-patient basis, the corresponding values of LS were 0.91, 0.85, 0.937, and 0.874, respectively. Statistically significant differences were not found in the sensitivity, specificity, AUC, and Q* index between 18F-FDG-PET and LS on per-bowel-segment basis. |
Good |
| 104. Shyn PB, Mortele KJ, Britz-Cunningham SH, et al. Low-dose 18F-FDG PET/CT enterography: improving on CT enterography assessment of patients with Crohn disease. Journal of Nuclear Medicine. 51(12):1841-8, 2010 Dec. |
Observational-Dx |
13 patients |
To evaluate the diagnostic efficacy of low-dose, combined 18F-FDG PET/CT enterography (PET/CTE), compared with CT enterography (CTE) alone, in theassessment of patients with Crohn disease. |
In 3 (23.1%) of 13 patients, 18F-FDG uptake using PET/CTE revealed active inflammation in a bowel segment not evident using CTE (n = 2) or revealedan enterocolic fistula missed with CTE (n = 1). Visual interpretation of both PET/CTE and CTE images detected the presence of disease in all bowel segments with more than mild inflammation (sensitivity, 100%; specificity, 89.7%; positive predictive value, 78.9%; and negative predictive value, 100%). Correlation to inflammation grade per patient was the strongest for the SUVmax ratio (0.735, P = 0.004) and SUVmax (0.67, P = 0.013), as compared with the CTE score (0.62, P = 0.024). Correlation with inflammation per bowel segment was higher for the CTE score (0.79, P < 0.0001) than the SUVmax ratio (0.62, P < 0.0001) or SUVmax (0.48, P < 0.0001). SUVmax correlated strongly with serum C-reactive protein (0.82, P = 0.023), but CTE score did not. |
2 |
| 105. Schnitzler F, Fidder H, Ferrante M, et al. Mucosal healing predicts long-term outcome of maintenance therapy with infliximab in Crohn's disease. Inflamm Bowel Dis. 2009;15(9):1295-1301. |
Observational-Tx |
214 patients |
To investigate the impact of mucosal healing on long-term outcome in the subgroup of patients who underwent a lower gastrointestinal endoscopy before the start of infliximab therapy and who underwent a follow-up endoscopy during therapy with infliximab. |
Mucosal healing was observed in 67.8% of the 183 initial responders (n = 124), with 83 patients having complete healing (45.4%) and 41 having partial healing (22.4%). Scheduled infliximab treatment from the start resulted in mucosal healing more frequently (76.9% mucosal healing rate) than episodic treatment (61.0% mucosal healing rate; P=0.0222, OR 2.14, 95% CI 1.11–4.12). Concomitant treatment with corticosteroids had a negative impact on mucosal healing (37.9% in patients with corticosteroids vs 63.2% in patients without corticosteroids; P=0.021, OR 0.36, 95% CI 0.16–0.80). Mucosal healing was associated with a significantly lower need for major abdominal surgery during long-term follow-up (14.1% of patients with mucosal healing needed major abdominal surgery vs 38.4% of patients without mucosal healing; P<0.0001). |
2 |
| 106. De Cruz P, Kamm MA, Prideaux L, Allen PB, Moore G. Mucosal healing in Crohn's disease: a systematic review. Inflamm Bowel Dis. 2013;19(2):429-444. |
Review/Other-Dx |
N/A |
A systematic review to assess mucosal healing in CD. |
No results stated in abstract. |
4 |
| 107. Soyer P, Boudiaf M, Sirol M, et al. Suspected anastomotic recurrence of Crohn disease after ileocolic resection: evaluation with CT enteroclysis. Radiology. 254(3):755-64, 2010 Mar. |
Observational-Dx |
40 consecutive patients, 2 independent readers |
To determine the utility of CT-E for characterization of the status of the anastomotic site in patients with CD who had previously undergone ileocolic resection. Written informed consent was prospectively obtained from all patients. Readers were blinded. |
In the diagnosis of anastomotic recurrence, severe anastomotic stenosis was the most sensitive finding (95% [20/21 patients]; 95% CI, 76.18%, 99.88%), both comb sign and stratification had 95% specificity (18/19 patients; 95% CI, 73.97%, 99.87%), and stratification was the most accurate finding (92% [37/40 patients]; 95% CI, 79.61%, 98.43%). In the diagnosis of fibrostenosis, both severe anastomotic stenosis and anastomotic wall thickening were 100% sensitive (8/8 patients; 95% CI, 63.06%, 100.00%), and using an association among 5 categorical variables, including severe anastomotic stenosis, anastomotic wall thickening with normal or mild mucosal enhancement, absence of comb sign, and absence of fistula, yielded 88% sensitivity (7/8 patients; 95% CI, 47.35%, 99.68%), 97% specificity (31/32 patients; 95% CI, 83.78%, 99.92%), and 95% accuracy (38/40 patients; 95% CI, 83.08%, 99.39%). CT-E yields objective and relatively specific morphologic criteria that help differentiate between recurrent disease and fibrostenosis at the anastomotic site after ileocolic resection for CD. |
1 |
| 108. Adler J, Punglia DR, Dillman JR, et al. Computed tomography enterography findings correlate with tissue inflammation, not fibrosis in resected small bowel Crohn's disease. Inflamm Bowel Dis. 18(5):849-56, 2012 May. |
Observational-Dx |
22 patients |
To compare CT enterography findings with histology from surgically resected specimens. |
In all, 22 patients met inclusion criteria. Inflammatory CT enterography findings correlated with histologic inflammation (rho = 0.52). Strictures believed to be “active” on CT enterography were more inflamed at histology (P=0.0002). Strictures lacking inflammatory findings on CT enterography or considered "inactive" were not associated with greater histologic fibrosis or significant histologic inflammation. Upstream dilation was associated with greater tissue fibrosis in univariate (P=0.014) but not in multivariate analysis (P=0.53). Overall, histologic fibrosis correlated best with histologic inflammation (rho = 0.52). Strictures on CT enterography with the most active disease activity also had the most fibrosis on histology. |
2 |
| 109. Bruining DH, Bhatnagar G, Rimola J, Taylor S, Zimmermann EM, Fletcher JG. CT and MR enterography in Crohn's disease: current and future applications. [Review]. Abdom Imaging. 40(5):965-74, 2015 Jun. |
Review/Other-Dx |
N/A |
To review current and future applications of CT and MR enterography in Crohn's disease. |
No results stated in abstract. |
4 |
| 110. Bruining DH, Loftus EV Jr, Ehman EC, et al. Computed tomography enterography detects intestinal wall changes and effects of treatment in patients with Crohn's disease. Clin Gastroenterol Hepatol. 9(8):679-683.e1, 2011 Aug. |
Observational-Dx |
63 patients |
To perform a retrospective study of patients with Crohn's disease who had undergone serial CTE imaging while receiving infliximab. |
Of 105 lesions, 52 (49.5%) improved, 11 (10.5%) remained unchanged, and 42 (40.0%) worsened. Per patient, 28 (44.4%) were responders, 12 (19.0%) were partial responders, and 23 (36.5%) were nonresponders. The radiologic response had poor-to-fair agreement with symptoms, endoscopic appearance, and levels of C-reactive protein at time of second CTE (kappa = 0.26, 0.07, and 0.30 respectively). |
3 |
| 111. Grand DJ, Guglielmo FF, Al-Hawary MM. MR enterography in Crohn's disease: current consensus on optimal imaging technique and future advances from the SAR Crohn's disease-focused panel. [Review]. Abdom Imaging. 40(5):953-64, 2015 Jun. |
Review/Other-Dx |
N/A |
To provide the current consensus on optimal imaging technique and future advances from the SAR Crohn's disease-focused panel. |
No results stated in abstract. |
4 |
| 112. Bruining DH, Zimmermann EM, Loftus EV Jr, et al. Consensus Recommendations for Evaluation, Interpretation, and Utilization of Computed Tomography and Magnetic Resonance Enterography in Patients With Small Bowel Crohn's Disease. Radiology. 286(3):776-799, 2018 Mar. |
Review/Other-Dx |
N/A |
To provide consensus recommendations for evaluation, interpretation and utlization of computed tomography and magnetic resonance enterography in patients with small bowel Crohn's disease. |
No results stated in abstract. |
4 |
| 113. Ordas I, Rimola J, Rodriguez S, et al. Accuracy of magnetic resonance enterography in assessing response to therapy and mucosal healing in patients with Crohn's disease. Gastroenterology. 146(2):374-82.e1, 2014 Feb. |
Observational-Dx |
48 patients |
To assess the accuracy of magnetic resonance enterography (MRE) in monitoring response to therapy in patients with Crohn's disease (CD) using ileocolonoscopy as a reference standard. |
MRE determined ulcer healing with 90% accuracy and endoscopic remission with 83% accuracy. The mean CDEIS and MaRIA scores significantly changed at week 12 in segments with ulcer healing, based on endoscopic examination (CDEIS: 21.28 +/- 9.10 at baseline vs 2.73 +/- 4.12 at 12 weeks; P < .001 and MaRIA: 148 patients 8.86 +/- 9.50 at baseline vs 8.73 +/- 5.88 at 12 weeks; P < .001). The MaRIA score accurately detected changes in lesion severity (Guyatt score: 1.2 and standardized effect size: 1.07). MRE was as reliable as endoscopy in assessing healing; no significant changes in CDEIS or MaRIA scores were observed in segments with persistent ulcers, based on endoscopic examination (CDEIS: 26.43 +/- 9.06 at baseline vs 20.77 +/- 9.13 at 12 weeks; P = .18 and MaRIA: 22.13 +/- 8.42 at baseline vs 20.77 +/- 9.17 at 12 weeks; P = .42). The magnitude of change in CDEIS scores correlated with those in MaRIA scores (r = 0.51; P < .001). |
3 |
| 114. Hudson JM, Williams R, Tremblay-Darveau C, et al. Dynamic contrast enhanced ultrasound for therapy monitoring. [Review]. Eur J Radiol. 84(9):1650-7, 2015 Sep. |
Review/Other-Dx |
N/A |
To review the principles and methodology of DCE-US, especially as applied to anti-angiogenic cancer therapies. |
No results stated in abstract. |
4 |
| 115. Girlich C, Schacherer D, Jung EM, Schreyer A, Buttner R. Comparison between a clinical activity index (Harvey-Bradshaw-Index), laboratory inflammation markers and quantitative assessment of bowel wall vascularization by contrast-enhanced ultrasound in Crohn's disease. Eur J Radiol. 81(6):1105-9, 2012 Jun. |
Observational-Dx |
45 patients |
To compare between a clinical activity index (Harvey-Bradshaw-Index), laboratory inflammation markers and quantitative assessment of bowel wall vascularization by contrast-enhanced ultrasound in Crohn's disease. |
Analysis of the 41 finally included patients revealed a correlation of CRP to HBI and TTP[s], respectively. Moreover, an association was found for HBI and TTP[s] and for HBI and TTP[s]/Peak [%]. Analysis of 34 patients with a Peak [%] >/= 25 showed a close association of HBI and CRP. Besides, in these patients CRP correlated to TTP[s] and to TTP[s]/Peak [%]. We found a strong negative correlation between HBI and TTP[s] (r = -0.645, p<0.01), thus, the higher the clinical activity the shorter the time-to-peak. |
3 |
| 116. Wilkens R, Novak KL, Lebeuf-Taylor E, Wilson SR. Impact of Intestinal Ultrasound on Classification and Management of Crohn's Disease Patients with Inconclusive Colonoscopy. Can J Gastroenterol Hepatol. 2016:8745972, 2016. |
Observational-Dx |
150 patients |
To investigate the potential contribution of bowel US to the detection and correct classification of inflammation in CD and to examine a possible influence on disease management by way of evaluating patients in whom the full extent of disease is evident on US only |
From 115 patients with temporally related ileocolonoscopy and ultrasound, 41 had disease fully assessed on ultrasound only, with complications in 26/41.Twenty-nine of 41 had mild or no endoscopic inflammation with moderate or severe disease on ultrasound at the same segment or at a segment proximal to the reach of the endoscope. Changes in management were significantly attributed to ultrasound in 22 of these 29 patients. |
3 |
| 117. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
