Clinical significance of isolated abnormal intestinal findings in magnetic resonance enterography in patients with suspected small bowel disease

Alahdab, Yeşim Özen; Demirtaş, Coşkun Özer; Kani, Haluk Tarık; Tüney, Davut; Şeker, Lamia; Tolu, Tugba; Atuğ, Özlen

doi:10.1007/s00261-019-02297-5

Cited by 1 publication

(1 citation statement)

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“…Firstly, this significant improvement of the revised model may be because a larger number of features were considered including radiological and laboratory findings in addition to others already considered earlier (8). This reiterates the fact that clinical decisions should not be based on a restricted number of modalities similar to that shown by Alahdab et al (14). Second, a multivariate regression with bootstrap validation and nomograms was used to evaluate and select relevant features, which aided in better Figure 6.…”

Section: Discussionmentioning

confidence: 83%

Revised Algorithmic Approach to Differentiate Between Nonspecific and Specific Etiologies of Chronic Terminal Ileitis

et al. 2023

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INTRODUCTION: Chronic isolated terminal ileitis (TI) may be seen in Crohn's disease (CD) and intestinal tuberculosis (ITB) in addition to other etiologies that may be managed symptomatically. We developed a revised algorithm to distinguish patients with a specific etiology from a nonspecific etiology. METHODS: Patients with chronic isolated TI followed up from 2007 to 2022 were retrospectively reviewed. A specific (ITB or CD) diagnosis was made based on standardized criteria, and other relevant data were collected. Using this cohort, validation of a previously suggested algorithm was conducted. Furthermore, based on the results of a univariate analysis, a multivariate analysis with bootstrap validation was used to develop a revised algorithm. RESULTS: We included 153 patients (mean age 36.9 ± 14.6 years, males—70%, median duration—1.5 years, range: 0–20 years) with chronic isolated TI of whom 109 (71.2%) received a specific diagnosis (CD-69, ITB-40). On multivariate regression and validation statistics with a combination of clinical, laboratory, radiological, and colonoscopic findings, an optimism corrected c-statistic of 0.975 and 0.958 was obtained with and without histopathological findings, respectively. Revised algorithm, based on these, showed sensitivity, specificity, positive and negative predictive values, and overall accuracy of 98.2% (95% CI: 93.5–99.8), 75.0% (95% CI: 59.7–86.8), 90.7% (95% CI: 85.4–94.2), 94.3% (95% CI: 80.5–98.5) and 91.5%(95% CI:85.9–95.4), respectively. This was more sensitive and specific than the previous algorithm (accuracy 83.9%, sensitivity 95.5%, and specificity 54.6%). DISCUSSION: We developed a revised algorithm and a multimodality approach to stratify patients with chronic isolated TI into specific and nonspecific etiologies with an excellent diagnostic accuracy, which could potentially avoid missed diagnosis and unnecessary side effects of treatment.

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Section: Discussionmentioning

confidence: 83%