MR Enterography of the Ileoanal Pouch: Descriptive Radiologic Analysis With Endoscopic and Pathologic Correlation

Sahi, Kamaldeep Singh; Lee, Karen; Moss, Alan C.; Yee, Eric U.; Allard, Felicia D.; Brook, Alexander; Mortelé, Koenraad J.

doi:10.2214/ajr.14.14212

Cited by 15 publications

(3 citation statements)

References 38 publications

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“…2012 [18] reported on CT Abdomen and Sahi et al . 2015 [23] reported on MRI abdomen. The logs odd ratio was 3.21 (95% CI 1.74–4.67) with an i 2 value of 0% suggesting insignificant heterogeneity and a negative likelihood ratio of 0.18 (95% CI 0.07–0.44) (Supplementary Information, Supplemental digital content 1, http://links.lww.com/EJGH/A911).…”

Section: Resultsmentioning

confidence: 99%

Sensitivity and specificity of diagnostic modalities in pouchitis: a systematic review and meta-analysis

Nieto,

Iqbal,

Vinci

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Restorative proctocolectomy (RPC) is the most common surgical procedure to restore gastrointestinal continuity after surgical resection of the colon and rectum. Pouchitis is a common complication with several different modalities that can be used to aid diagnosis. This systematic review and meta-analysis aimed at exploring the sensitivity and specificity these diagnostic modalities. The medical literature was searched using MEDLINE, EMBASE and EMBASE classic and PubMed from 1978 to June 2022. We calculated descriptive statistics using sensitivity, specificity, and false-positive rate of the primary studies and also their positive and negative likelihood ratios, and their diagnostic odds ratios. The screen found 5477 records with 13 studies being included. Faecal lactoferrin was found to have the highest pooled sensitivity and specificity of 98% and 88% respectively with imaging modalities coming in second and faecal calprotectin third with pooled sensitivities and specificities of 87% and 79% and 74% and 81% respectively. Faecal biomarkers particularly lactoferrin and imaging modalities may have an important role to play in diagnosing pouchitis. Importantly due to delays in availability of pouchoscopy, our data supports early ordering of these tests to help delineate from other causes. Further studies are required with larger cohort sizes to further validate these tests.

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Section: Resultsmentioning

confidence: 99%

Sensitivity and specificity of diagnostic modalities in pouchitis: a systematic review and meta-analysis

Nieto,

Iqbal,

Vinci

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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“…MR has a higher sensitivity to detect compromise of the remaining rectum and rule out the presence of perianal disease (11) . In a prospective study in patients with a pouch, a good correlation between the findings of the resonance and the endoscopic scores was found (r=0.61; P=0.0005), with a positive likelihood ratio (LR) of four and a negative LR of 0.18 (29) .…”

Section: Imaging Studymentioning

confidence: 96%

Diagnostic and Management Approach to Pouchitis in Inflammatory Bowel Disease

Sedaño

Núñez

Quera

2020

Arq. Gastroenterol.

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In patients with ulcerative colitis refractory to medical therapy, total proctocolectomy and posterior ileal-anal pouch anastomosis is the standard surgical therapy. One of the possible complications is pouchitis. Depending on the duration of the symptoms, it can be classified as acute, recurrent, or chronic. The latter, according to the response to therapy, can be defined as antibiotic-dependent or refractory. The treatment of pouchitis is based on the use of antibiotics and probiotics. Thiopurine and biological therapy have been suggested in patients with refractory pouchitis. Special care should be taken in the endoscopic surveillance of these patients, especially if they present risk factors such as dysplasia or previous colorectal cancer, primary sclerosing cholangitis or ulcerative colitis for more than 10 years.

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“…18 The investigators calculated composite and subscores of MRI inflammation scores that were correlated with endoscopic inflammation scores. 53 Pelvic MRI findings of pouchitis include thickened pouch wall (>2 mm with adequate distention), parapouch lymphadenopathy (more than 3 nodes or 1 >1-cm node), mucosal hyperenhancement, fat stranding, or parapouch fluid collection. 42 MRI and MRE play a major role in the diagnosis, differential diagnosis, disease monitoring, and assessment of response to treatment of CD of the pouch or perianal or parapouch abscess(es) or fistula(s) of other causes.…”

Section: Inflammatory Disorders Of the Pouchmentioning

confidence: 99%

Radiographic Evaluation of Ileal Pouch Disorders: A Systematic Review

Shen,

Bruining,

2024

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Radiographic imaging of abdomen and pelvis plays an important role in the diagnosis and management of ileal pouch disorders with modalities including computed tomography, magnetic resonance imaging, contrasted pouchography, and defecography. OBJECTIVES: A systematic review of the literature was performed and applications of cross-sectional imaging, pouchography, defecography, and ultrasonography are described. DATA SOURCES: PubMed, Google Scholar, and Cochrane database. STUDY SELECTION: Relevant articles on endoscopy in ileal pouches published between Jan 2003 and June 2023 in English were included based on PRISMA guidelines. INTERVENTION: Main abdominal and pelvic imaging modalities and their applications in the diagnosis of ileal pouch disorders were included. MAIN OUTCOME MEASURES: Accuracy in characterization of the ileal pouch disorders. RESULTS: Computed tomography is the test of the choice for the evaluation of acute anastomotic leaks, perforation, and abscess(es). Magnetic resonance imaging of the pelvis is suitable for the evaluation of chronic anastomotic leaks and their associated fistulas and sinus tracts, as well as for the penetrating phenotype of Crohn’s disease of the pouch. Computed tomography enterography and magnetic resonance enterography are useful in the assessment of intraluminal, intramural, and extraluminal disease processes of the pouch and prepouch ileum. Water-soluble contrast pouchography is particularly useful for the evaluation of acute or chronic anastomotic leaks and outlines the shape and configuration of the pouch. Defecography is the key modality to evaluate structural and functional pouch inlet and outlet obstructions. Ultrasonography can be performed to assess the pouch in experienced IBD centers. LIMITATIONS: This is a qualitative, not quantitative review of mainly case series and case reports. CONCLUSIONS: Abdominopelvic imaging along with clinical and endoscopic evaluation is imperative for the accurate assessment of structural, inflammatory, functional, and neoplastic disorders. See video from symposium.

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MR Enterography of the Ileoanal Pouch: Descriptive Radiologic Analysis With Endoscopic and Pathologic Correlation

Cited by 15 publications

References 38 publications

Sensitivity and specificity of diagnostic modalities in pouchitis: a systematic review and meta-analysis

Sensitivity and specificity of diagnostic modalities in pouchitis: a systematic review and meta-analysis

Diagnostic and Management Approach to Pouchitis in Inflammatory Bowel Disease

Radiographic Evaluation of Ileal Pouch Disorders: A Systematic Review

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