Title: Role of MR Enterography (MRE) in Small Bowel Diseases
Authors: Dr Gaurav Gupta, Dr Shikha Sood, Dr Sanjiv Sharma, Dr Balraj Singh, Dr Vijay Thakur, Dr Brij Sharma
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.108
Abstract
Introduction: Over recent years there have been significant advances in radiological techniques to better define small bowel lesions. Lack of ionising radiation, superior soft-tissue contrast resolution, capability of dynamic contrast enhanced imaging and capability of cine imaging to assess peristalsis makes MRE potential ideal imaging modality to assess small bowel pathologies.
Objective: The purpose of this article is to describe the role of MRE in diagnosis of small bowel diseases and guiding the course of management in patients of small bowel diseases.
Materials and Methods: MRE was performed on 30 patients who presented to outpatient department of surgery and general medicine with abdominal complaints. The level of agreement (%) of MR diagnosis with reference to a gold standard (histopathology, Fine Needle Aspiration Cytology, response to treatment) was calculated. The number and proportion of patients among whom the operating surgeons changed their course of management (that might have adopted in the absence of MR diagnosis) was calculated.
Observations: Four of 30 patients had Crohn's disease (CD) on MRE. Ten (33.3%) of the 30 patients who underwent MRE were operated. Adhesive bands (2.7%) was the most common operative finding. Histopathological examination was done in 43.4% of patients where CD (16.7%) was the most common diagnosis. Course of management changed in 56.7% of patients after MRE. There was 100% agreement between MR diagnosis and histopathology in all the cases except CD where there was 80% agreement.
Conclusions: MRE has high diagnostic accuracy comparable with histopathological diagnosis except in CD where diagnostic accuracy was 80%.MRE is very useful tool for clinician and surgeon in deciding the optimal course of management.
Keywords: MR enterography, small intestine, Crohn's disease.
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