Elisa Amzallag-Bellenger MD, Presenter: Nothing to Disclose

Ana Ruiz MD, Abstract Co-Author: Nothing to Disclose

Ammar Oudjit, Abstract Co-Author: Nothing to Disclose

Coralie Barbe, Abstract Co-Author: Nothing to Disclose

Alban Colosio, Abstract Co-Author: Nothing to Disclose

Christine Caroline Hoeffel MD, Abstract Co-Author: Nothing to Disclose

To prospectively evaluate the diagnostic performance of magnetic resonance enterography (MRE; performed without enteroclysis) in the detection of small-bowel neoplasms in symptomatic patients.

The study protocol was approved by the human research committee, and all patients gave informed consent. 62 patients (30 male, 32 women; mean age 53 years; age range: 19-84 years) who were clinically suspected of having small-bowel neoplasm underwent MRE. Three radiologists evaluated MRE for the presence of focal bowel wall thickening, small-bowel masses and/or stenosis and scored the likelihood of small bowel neoplasm . Discrepancies were resolved by consensus. Positive MR enterography findings were compared with histology obtained after surgery(n=31) or endoscopy(n=1). Negative MRE results were compared with enteroscopy (n=1), capsule endoscopy (n=6) or conventional CT scan or enteroclysis with subsequent clinical follow-up (n=23).

MRE enabled correct detection of 49 neoplasms in 28 patients: 6 patients with carcinoid tumors (12 lesions) 3 adenocarcinomas, 7 stromal tumors in three patients, 10 polyps in four patients, 6 lymphomas in five patients, 6 metastases in two patients, 1 leiomyoma, 1 adenoma, 3 lipomas in three patients. There was one false negative on a per patient basis: one carcinoid tumor, and 3 false positive results (3 cecal adenocarcinoma with extension on the small bowel). Mean tumor size was 27mm (diameter range 6-70mm).Overall sensitivity, specificity, positive predictive and negative predictive values in identifying small-bowel lesions were on a patient-basis the same for all readers, respectively 96.5 % CI 95% [0.899-1.032] , 90.9 % CI 95% [0.811-1.007], 90.3% and 96.7 % and on a per- lesion basis the same for Readers 1 and 2, respectively of 85.7% CI 95% [0.759-0.955], 90.9% CI 95%[0.811-1.007], 93.3% and 81.1% and 82.3% CI 95% [0.719-0.928], 90.9% CI 95% [0.811-1.007], 93.3% and 76.9% for reader 3. Interobserver agreement ranged between 0.94 and 0.97 on a patient basis.

MR enterography is a well-tolerated, reproductible, non ionizing imaging modality, allowing detection of small bowel neoplasms with high sensitivity in patients with clinical suspicion of small-bowel tumor.

MR enterography has a high sensitivity in the detection of small bowel neoplasms.

Amzallag-Bellenger, E, Ruiz, A, Oudjit, A, Barbe, C, Colosio, A, Hoeffel, C, Small Bowel Neoplasms: Prospective Evaluation of MR Enterography.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012577.html