Accuracy of magnetic resonance enterography in the preoperative assessment of patients with Crohn's disease of the small bowel

Fecha de publicación: 01/05/2017

Autores de IIS La Fe

Salvador Pous Serrano

Autor
Matteo Frasson

Autor
Rosario Ana Palasi Gimenez

Autor
Gonzalo Sánchez Jordá

Autor
Margarita Mercedes Llavador Ros

Autor
Pilar Nos Mateu

Autor
Eduardo García-Granero Ximénez

Autor

Participantes ajenos a IIS La Fe

Pamies-Guilabert, J

Grupos

Cirugía digestiva y Cuidados perioperatorios

Leader

Matteo Frasson
Enfermedad Inflamatoria Intestinal

Leader

Pilar Nos Mateu

Abstract

Aim To assess the accuracy of magnetic resonance enterography in predicting the extension, location and characteristics of the small bowel segments affected by Crohn's disease. Method This is a prospective study including a consecutive series of 38 patients with Crohn's disease of the small bowel who underwent surgery at a specialized colorectal unit of a tertiary hospital. Preoperative magnetic resonance enterography was performed in all patients, following a homogeneous protocol, within the 3 months prior to surgery. A thorough exploration of the small bowel was performed during the surgical procedure; calibration spheres were used according to the discretion of the surgeon. The accuracy of magnetic resonance enterography in detecting areas affected by Crohn's disease in the small bowel was assessed. The findings of magnetic resonance enterography were compared with surgical and pathological findings. Results Thirty-eight patients with 81 lesions were included in the study. During surgery, 12 lesions (14.8%) that were not described on magnetic resonance enterography were found. Seven of these were detected exclusively by the use of calibration spheres, passing unnoticed at surgical exploration. Magnetic resonance enterography had 90% accuracy in detecting the location of the stenosis (75.0% sensitivity, 95.7% specificity). Magnetic resonance enterography did not precisely diagnose the presence of an inflammatory phlegmon (accuracy 46.2%), but it was more accurate in detecting abscesses or fistulas (accuracy 89.9% and 98.6%, respectively). Conclusion Magnetic resonance enterography is a useful tool in the preoperative assessment of patients with Crohn's disease. However, a thorough intraoperative exploration of the entire small bowel is still necessary.

Datos de la publicación

ISSN/ISSNe:: 1462-8910, 1463-1318
Tipo:: Article
Páginas:: 126-133
DOI:: 10.1111/codi.13613
Factor de Impacto:: 1,229 SCImago ℠
Cuartil:: Q2 SCImago ℠

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Filiaciones

Pous-Serrano, S:: Department of General Surgery, Colorectal Unit, La Fe University Hospital, Valencia, Spain

La Fe Univ Hosp, Dept Gen Surg, Colorectal Unit, Valencia, Spain
Frasson, M:: Department of General Surgery, Colorectal Unit, La Fe University Hospital, Valencia, Spain

La Fe Univ Hosp, Dept Gen Surg, Colorectal Unit, Valencia, Spain
Palasí Giménez R:: Department of General Surgery, Colorectal Unit, La Fe University Hospital, Valencia, Spain
Sanchez-Jorda, G:: Department of Radiology, La Fe University Hospital, Valencia, Spain

La Fe Univ Hosp, Dept Radiol, Valencia, Spain
Pamies-Guilabert, J:: Department of Radiology, La Fe University Hospital, Valencia, Spain

La Fe Univ Hosp, Dept Radiol, Valencia, Spain
Llavador Ros M:: Department of Pathology, La Fe University Hospital, Valencia, Spain
Nos Mateu P:: Department of Gastroenterology, Inflammatory Bowel Disease Unit, La Fe University Hospital, Valencia, Spain
Garcia-Granero, E:: Department of General Surgery, Colorectal Unit, La Fe University Hospital, Valencia, Spain

La Fe Univ Hosp, Dept Gen Surg, Colorectal Unit, Valencia, Spain