Gabriele Masselli MD, Presenter: Nothing to Disclose

Emanuele Casciani, Abstract Co-Author: Nothing to Disclose

Elisabetta Polettini MD, Abstract Co-Author: Nothing to Disclose

Stefano Caprasecca, Abstract Co-Author: Nothing to Disclose

Dino D'Amico, Abstract Co-Author: Nothing to Disclose

Gianfranco Gualdi, Abstract Co-Author: Nothing to Disclose

To prospectively compare the accuracy of CT and MR enterography for the detection of small bowel diseases.

The study group included 137 patients suspected of having small-bowel tumor (n=21), active IBD (n=45), unexplained gastrointestinal bleeding (n=36), refractory celiac sprue (n =14), and low-grade small-bowel obstruction (n =21) . CT enterography was performed by using a 128–detector row CT scanner and MR enterography was performed by using a 1.5-T imager. Patients were instructed to drink 1500 mL of a 3% sorbitol solution during 45 minutes before undergoing CT enterography. After completion of CT scanning, patients underwent to MR enterography (the time interval between two modalities was less than 5 minutes). Two radiologists reviewed independently CT and MR enterographic images for the detection of small bowel diseases. Accuracy values of CT and MR enterography were evaluated with the receiver operating characteristic method with results of endoscopies, videocapsule endoscopy, histopathologic analysis, or clinical follow-up as reference standards. Sensitivity values of CT and MR enterography for detection of small bowel diseases were compared by using the McNemar test.  

Differences in areas under the receiver operating characteristic curves for CT (0.895 and 0.874) and MR enterography (0.955 and 0.915) for readers 1 and 2, respectively in the detection of small bowel disease were not significant (P>.015). Both CT and MR enterography allowed the detection of active Crohn disease (n = 39), small-bowel tuberculosis (n=2), small-bowel masses (n = 13), lymphoma complicating celiac disease (n = 4), and low-grade small-bowel obstruction (n= 12). CT enterography missed the presence of jejunal polyps (n=2), gallstone ileus (n=2), ileal adenocarcinoma (n=1), jejunal lymphoma (n=1), ileal carcinoid (n=1), Meckel diverticulum (n=1), detected on MR enterography, that missed ileal angiodysplasia (n=1). MR enterography was statistically superior to CT enterography (p<0.05) for detection of non-inflammatory diseases.  

CT and MR enterography have similar accuracy for detecting small bowel diseases, but MR showed a better accuracy in detecting non inflammatory diseases.

CT and MR enterography are accurate modalities for the detection of small bowel diseases. MR enterography showed a better accuracy than CT enterography in detecting non-inflammatory diseases.

Masselli, G, Casciani, E, Polettini, E, Caprasecca, S, D'Amico, D, Gualdi, G, Small Bowel Diseases: Prospective Comparison of CT Enterography and MR Enterography.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003394.html