Endoscopy and MR enteroclysis: Equivalent tools in predicting clinical recurrence in patients with Crohn's disease after ileocolic resection
✍ Scribed by Stavroula Koilakou; Johannes Sailer; Philipp Peloschek; Arnulf Ferlitsch; Harald Vogelsang; Wolfgang Miehsler; Joel Fletcher; Karl Turetschek; Wolfgang Schima; Walter Reinisch
- Publisher
- John Wiley and Sons
- Year
- 2010
- Tongue
- English
- Weight
- 156 KB
- Volume
- 16
- Category
- Article
- ISSN
- 1078-0998
No coin nor oath required. For personal study only.
✦ Synopsis
Background: Ileocolonoscopy poses the gold standard in the evaluation of postoperative recurrence of Crohn's disease (CD) at the site of ileocolonic anastomosis. Magnetic resonance enteroclysis (MRE) on the other hand is a promising technique for small bowel imaging. The aim was to compare MRE and ileocolonoscopy for predicting clinical recurrence in CD patients who have undergone ileocolonic resection.
Methods:
We included 29 patients in the study. The median time since index operation was 35 months and between ileocolonoscopy and MRE was 3 days. Patients were followed up for a maximum of 2 years unless clinical recurrence occurred earlier. Endoscopic findings were evaluated on a 5-grade scale (i0-i4), whereas MRE findings on the neoterminal ileum and anastomosis were assessed according to a previously validated 4-grade scale MR score (MR0-MR3).
Results: By classifying patients into subgroups of endoscopic severity of postoperative recurrence using as a threshold an endoscopic score of i3, we found that 10% of patients in the i0 to i2 group had a clinical recurrence during the 2-year follow-up period as compared to 52.6% of subjects with i3 to i4 (P ¼ 0.043). The corresponding clinical exacerbation rates in the subgroups based on MRE severity assessment were 12.5% for MR0 to MR1 and 50% for MR2 to MR3 (P ¼ 0.09).
Conclusions: Our data suggest that colonoscopy and MR enteroclysis are of similar value to predict the risk of clinical recurrence in postoperative patients with Crohn's disease.