Comparison of MR enterography and histopathology in the evaluation of pediatric Crohn disease

Background While MR enterography (MRE) is commonly used to identify segments of bowel affected by Crohn disease in children, there is little data to support this practice. Objective To assess the ability of MRE to identify segments of small bowel and colon affected by pediatric Crohn disease using h...

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Bibliographic Details
Published in:Pediatric radiology 2011-12, Vol.41 (12), p.1552-1558
Main Authors: Dillman, Jonathan R., Ladino-Torres, Maria F., Adler, Jeremy, DeMatos-Malliard, Vera, McHugh, Jonathan B., Khalatbari, Shokoufeh, Strouse, Peter J.
Format: Article
Language:English
Subjects:
Adolescent
Child
Colon - pathology
Crohn Disease - pathology
Female
Humans
Imaging
Intestine, Small - pathology
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Neuroradiology
Nuclear Medicine
Oncology
Original Article
Pediatrics
Radiology
Reproducibility of Results
Sensitivity and Specificity
Ultrasound
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Summary:Background While MR enterography (MRE) is commonly used to identify segments of bowel affected by Crohn disease in children, there is little data to support this practice. Objective To assess the ability of MRE to identify segments of small bowel and colon affected by pediatric Crohn disease using histopathology as the reference standard. Materials and methods Pediatric MRE examinations performed between April 2009 and December 2010 were identified. Subjects were excluded if they did not have Crohn disease, if they had Crohn disease but no correlative histopathology within 2 months of imaging, or if they had undergone prior bowel resection. Pertinent MRE and histopathology reports were reviewed, and normal and abnormal bowel segments were documented. Results Thirty-two pediatric MRE examinations were identified with correlative histopathology. MRE had an overall sensitivity of 94% for detecting the presence of Crohn disease, in general. At the bowel segmental level, MRE had a sensitivity of 66%, specificity of 90%, positive predictive value of 85% and negative predictive value of 76%. The terminal ileum was abnormal by MRE in 11 of 15 (73%) subjects lacking a diagnostic biopsy of this bowel segment. Conclusion MRE successfully identifies small bowel and colon segments affected by pediatric Crohn disease.
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-011-2186-0