Journal Article

Comparison of Capsule Endoscopy and Magnetic Resonance Enterography for the Assessment of Small Bowel Lesions in Crohn’s Disease

Begoña González-Suárez, Sonia Rodriguez, Elena Ricart, Ingrid Ordás, Jordi Rimola, Álvaro Díaz-González, Cristina Romero, Cristina Rodríguez de Miguel, Arantxa Jáuregui, Isis K Araujo, Anna Ramirez, Marta Gallego, Gloria Fernández-Esparrach, Ángels Ginés, Oriol Sendino, Josep Llach and Julian Panés

in Inflammatory Bowel Diseases

Volume 24, issue 4, pages 775-780
Published in print March 2018 | ISSN: 1078-0998
Published online March 2018 | e-ISSN: 1536-4844 | DOI: https://dx.doi.org/10.1093/ibd/izx107
Comparison of Capsule Endoscopy and Magnetic Resonance Enterography for the Assessment of Small Bowel Lesions in Crohn’s Disease

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Abstract

Background and Aims

Diagnostic yield of Small Bowel Capsule Endoscopy (SBCE) for the assessment of small bowel (SB) lesions is higher than radiologic imaging techniques. However, magnetic resonance enterography (MRE) data are scarce and inconclusive. Colon Capsule Endoscopy (CCE) is a new capsule modality. The primary aim of our study was to compare MRE and capsule endoscopy (CE) for the assessment of Crohn’s disease (CD). The secondary objectives were to compare the diagnostic accuracy of both CE modalities and changes in Montreal classification after each examination.

Methods

We included 47 patients with established (n = 32) or suspected CD (n = 15). MRE was performed first to rule out strictures. In patients with a suspected stricture by MRE, an Agile Patency Capsule was performed. SB disease activity was measured by MaRIA score (MRE) and Lewis Index (CE).

Results

SB lesions were found in 36 of47 patients with CE and in 21 of47 patients with MRE (76.6% vs 44.7%, P = 0.001). Jejunal inflammation was detected by CE in 31.9% of patients and by MRE in 6.4% of patients (15/47 vs 3/47; P = 0.03); lesions in ileum were detected in 57.4% of patients by CE, and in 21.3% of patients by MRE (27/ 47 vs 10/ 47; P = 0.04). Finally, in terminal ileum, CE showed lesions in 68.1% (32/47) of patients, whereas MRE detected lesions in 38.3% (18/ 47 patients), (P = 0.001). The original Montreal classification was changed in 53.1% of patients (25/ 47) based on CE findings and in 12.7% of patients (6/47) based on MRE findings (P < 0.05).

Conclusions

In our cohort CE was significantly superior to MRE for detecting SB lesions, mainly superficial and proximal lesions. CE is useful for a appropriate patients’ classification according to Montreal classification.

Keywords: small bowel capsule endoscopy; colon capsule endoscopy; magnetic resonance enterography

Journal Article.  4180 words.  Illustrated.

Subjects: Medicine and Health ; Clinical Medicine ; Gastroenterology ; Patient Education and Information ; Gastro-intestinal and Colorectal Surgery

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