caa a22 4500 445795441 CHVBK 20180317145123.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s10620-011-1781-0 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1781-0 Magnetic Resonance Enterography: Safe and Effective Imaging for Stricturing Crohn's Disease [Elektronische Daten] [Christina Ha, Nitin Kumar, Constantine Raptis, Vamsi Narra, Matthew Ciorba] Background: Symptomatic Crohn's disease (CD) patients often undergo diagnostic imaging studies for evaluation of disease activity or complications including bowel strictures and obstruction. Magnetic resonance enterography (MRE) provides information regarding disease activity, chronicity, and stricture formation without using ionizing radiation. Aim: Examine the use of MRE among CD patients presenting with symptoms suggesting obstruction in a tertiary care practice setting. Methods: We performed a retrospective study of all CD patients undergoing MRE at a tertiary IBD referral center over a 3-year study period including a subgroup analysis of patients presenting obstructive symptoms. Positive and negative findings from MRE were correlated with medical and surgical decision outcomes over the subsequent 90-day period. Results: In the study, 119 CD patients underwent 133 MRE scans, including 40 scans on individuals presenting with obstructive symptoms. Positive findings of CD including active inflammation, stricturing, and penetrating disease were more frequent in MREs ordered to evaluate obstructive symptoms (87.5%) compared other indications (58.1%, p=0.001). In patients presenting with obstructive symptoms, MRE findings assisted in directing a change of clinical management towards escalation of medical therapy in 55% and surgery in 32.5%. Review of surgical resection specimens corroborated MRE findings of disease activity and fibrosis in 92% of cases going to surgery. Conclusions: In practice-based use at a tertiary IBD referral center, MRE provided an effective, radiation-free alternative to computed tomography by providing valuable diagnostic information for evaluating and directing care in Crohn's disease, particularly for patients presenting with obstructive symptoms. Springer Science+Business Media, LLC, 2011 Crohn's disease nationallicence Magnetic resonance enterography nationallicence Obstructive symptoms nationallicence Ionizing radiation nationallicence CD : Crohn's disease nationallicence CT : Computed tomography nationallicence MRE : Magnetic resonance enterography nationallicence MR : Magnetic resonance nationallicence SBFT : Small bowel follow-through nationallicence SEM : Standard error of the mean nationallicence CTE : Computed tomography enterography nationallicence ACR : American College of Radiology nationallicence UC : Ulcerative colitis nationallicence Ha Christina Division of Gastroenterology, Washington University in St. Louis School of Medicine, 660 South Euclid, Campus Box 8124, 63110, St. Louis, MO, USA aut Kumar Nitin Division of Gastroenterology, Washington University in St. Louis School of Medicine, 660 South Euclid, Campus Box 8124, 63110, St. Louis, MO, USA aut Raptis Constantine Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA aut Narra Vamsi Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA aut Ciorba Matthew Division of Gastroenterology, Washington University in St. Louis School of Medicine, 660 South Euclid, Campus Box 8124, 63110, St. Louis, MO, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 2906-2913 0163-2116 56:10<2906 2011 56 10620 https://doi.org/10.1007/s10620-011-1781-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1781-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ha Christina Division of Gastroenterology, Washington University in St. Louis School of Medicine, 660 South Euclid, Campus Box 8124, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Kumar Nitin Division of Gastroenterology, Washington University in St. Louis School of Medicine, 660 South Euclid, Campus Box 8124, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Raptis Constantine Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Narra Vamsi Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Ciorba Matthew Division of Gastroenterology, Washington University in St. Louis School of Medicine, 660 South Euclid, Campus Box 8124, 63110, St. Louis, MO, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 2906-2913 0163-2116 56:10<2906 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer