MR enterography in Crohn’s disease: current consensus on optimal imaging technique and future advances from the SAR Crohn’s disease-focused panel

Grand, David; Guglielmo, Flavius F.; Al-Hawary, Mahmoud M.

doi:10.1007/s00261-015-0361-8

Cited by 79 publications

(52 citation statements)

References 47 publications

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“…100,101 CT enterography may result in suboptimal bowel distension without adequate patient compliance with oral contrast consumption. MRI optimized to evaluate the small bowel has also shown good sensitivity for the detection of Crohn’s disease 102 and small bowel tumors. 103 One recent series of 150 patients comparing the results of CT and MRI enterography for detecting small bowel tumors found that the sensitivity of MRI (93%) was actually higher than CT (76%; p=0.04).…”

Section: Resultsmentioning

confidence: 99%

The Surgical Management of Small Bowel Neuroendocrine Tumors

Howe¹,

Cardona²,

Fraker³

et al. 2017

Pancreas

295

188

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Small bowel neuroendocrine tumors (SBNETs) have been increasing in frequency over the past decades, and are now the most common type of small bowel tumor. Consequently, general surgeons and surgical oncologists are seeing more patients with SBNETs in their practices than ever before. The management of these patients is often complex, owing to their secretion of hormones, frequent presentation with advanced disease, and difficulties with making the diagnosis of SBNETs. Despite these issues, even patients with advanced disease can have long-term survival. There are a number of scenarios which commonly arise in SBNET patients where it is difficult to determine the optimal management from the published data. To address these challenges for clinicians, a consensus conference was held assembling experts in the field to review and discuss the available literature and patterns of practice pertaining to specific management issues. This paper summarizes the important elements from these studies and the recommendations of the group for these questions regarding the management of SBNET patients.

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Section: Resultsmentioning

confidence: 99%

The Surgical Management of Small Bowel Neuroendocrine Tumors

Howe¹,

Cardona²,

Fraker³

et al. 2017

Pancreas

295

188

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“…Recent data suggest that cross-sectional imaging may be useful in determining response to therapy, assessing bowel healing, and monitoring disease progression (6). The Society of Abdominal Radiology (SAR) formed a Crohn's Disease-Focused Panel, which has established standards for the technical performance of these examinations (Appendix 1) (7)(8)(9). CTE and MRE are now performed across a range of institutions, with the radiologic literature focusing on the technical aspects of diagnosis and identification of mural inflammation or penetrating complications, such as fistula and abscess, using various acquisition methods and imaging findings.…”

mentioning

confidence: 99%

Consensus Recommendations for Evaluation, Interpretation, and Utilization of Computed Tomography and Magnetic Resonance Enterography in Patients With Small Bowel Crohn’s Disease

et al. 2018

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Computed tomography and magnetic resonance enterography have become routine small bowel imaging tests to evaluate patients with established or suspected Crohn's disease, but the interpretation and use of these imaging modalities can vary widely. A shared understanding of imaging findings, nomenclature, and utilization will improve the utility of these imaging techniques to guide treatment options, as well as assess for treatment response and complications. Representatives from the Society of Abdominal Radiology Crohn's Disease-Focused Panel, the Society of Pediatric Radiology, the American Gastroenterological Association, and other experts, systematically evaluated evidence for imaging findings associated with small bowel Crohn's disease enteric inflammation and established recommendations for the evaluation, interpretation, and use of computed tomography and magnetic resonance enterography in small bowel Crohn's disease. This work makes recommendations for imaging findings that indicate small bowel Crohn's disease, how inflammatory small bowel Crohn's disease and its complications should be described, elucidates potential extra-enteric findings that may be seen at imaging, and recommends that cross-sectional enterography should be performed at diagnosis of Crohn's disease and considered for small bowel Crohn's disease monitoring paradigms. A useful morphologic construct describing how imaging findings evolve with disease progression and response is described, and standard impressions for radiologic reports that convey meaningful information to gastroenterologists and surgeons are presented. 2018, RSNA, AGA Institute, and Society of Abdominal Radiology This article is being published jointly in Radiology and Gastroenterology.

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“…MRE is highly accurate in detecting internal fistulas in CD, with sensitivities ranging from 71-100% and specificities from 92-100% (13,14). MRE is superior to CTE in detecting internal and perianal fistulas (15,16), has the major advantage of lacking ionizing radiation (11,(15)(16)(17) and has better contrast resolution (10,18). Therefore, MRE is the imaging modality of choice in CD, especially in young patients and for those requiring repetitive imaging (17,18).…”

Section: Discussionmentioning

confidence: 99%

“…MRE is superior to CTE in detecting internal and perianal fistulas (15,16), has the major advantage of lacking ionizing radiation (11,(15)(16)(17) and has better contrast resolution (10,18). Therefore, MRE is the imaging modality of choice in CD, especially in young patients and for those requiring repetitive imaging (17,18). Findings of CD on MRE are thickened bowel wall (>3 mm), increased wall enhancement, bowel wall edema, ulceration, perimural inflammation, and lymph node enhancement.…”

Section: Discussionmentioning

confidence: 99%