Preoperative Magnetic Resonance Enterography in Predicting Findings and Optimizing Surgical Approach in Crohn's Disease

Spinelli, Antonino; Fiorino, Gionata; Bazzi, Piero; Sacchi, Matteo; Bonifacio, Cristiana; Bastiani, Sarah De; Malesci, Alberto; Balzarini, Luca; Peyrin–Biroulet, Laurent; Montorsi, Marco; Danese, Silvio

doi:10.1007/s11605-013-2404-1

Cited by 29 publications

(16 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The accuracy of MRE in detecting stenoses in our study was also consistent with the results reported by the Italian group [11] .…”

Section: Discussionsupporting

confidence: 93%

“…In our study, MRE had lower specificity in detecting stenoses than abscesses or fistulas, a finding similar to that previously reported by Spinelli et al [11] . The accuracy of MRE in detecting stenoses in our study was also consistent with the results reported by the Italian group [11] .…”

Section: Discussionsupporting

confidence: 93%

“…MRE may prove useful during preoperative planning among Crohn's disease patients since it can diagnose small bowel and colonic lesions as well as extraintestinal lesions such as abscesses and fistulas [10][11][12][13] . Given that Crohn's disease follows a recurrent pattern, whereby patients will require multiple imaging examinations throughout their lives, the advantage of MRE over other imaging techniques lies in its lack of exposure to radiation [10,13] .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, preoperative MRE resulted in successful treatment of abscesses in 40% of falsepositive cases before the operation, which usually is advantageous considering the length of bowel resection and risk of postoperative complications. Also, others have found relatively low positive predictive value for abscesses in MRE, most probably due to preoperative antibiotic treatment [11,18] . Among the 4 false-negative fistula diagnoses using MRE, one of the patients had an abscess identified through MRE and was treated with percutaneous drainage preoperatively.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Intra-Abdominal Adhesions Make the Interpretation of Magnetic Resonance Enterography in Crohn's Disease More Difficult

Aaltonen¹,

Keränen²,

Carpelan-Holmström³

et al. 2016

Dig Surg

View full text Add to dashboard Cite

Aims: The present study compares preoperative magnetic resonance enterography (MRE) accuracy in diagnosing stenoses, abscesses and fistulas to intraoperative findings in Crohn's disease patients, and determines whether discordance between these methods alter surgical plans. Methods: Our study included 55 consecutive patients scheduled for elective surgery due to Crohn's disease in a single institution between January 2011 and May 2015, whose surgical findings were also compared to preoperative MREs. Data were retrospectively analyzed. Results: Among these 55 patients, we found 80 stenoses, 5 abscesses and 18 fistulas during surgery. The MRE sensitivity, specificity and accuracy, respectively, reached 100, 77.8 and 96.4% for stenoses; 80.0, 90.0 and 89.1% for abscesses; and 77.8, 83.8 and 81.8% for fistulas. The operative plan was modified for 7 patients (12.7%) due to erroneous MRE diagnoses. No patient needed conversion or an unplanned stoma placement due to an incorrect diagnosis using MRE. The MRE diagnosis did not agree with the surgical findings for 36 lesions, 16 of which resulted from adhesions that explained the incorrect MRE diagnoses. Conclusions: Hence, while MRE is a useful diagnostic tool preoperatively in Crohn's disease patients, the presence of intra-abdominal adhesions may cause erroneous diagnosis through MRE.

show abstract

“…The accuracy of MRE in detecting stenoses in our study was also consistent with the results reported by the Italian group [11] .…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Intra-Abdominal Adhesions Make the Interpretation of Magnetic Resonance Enterography in Crohn's Disease More Difficult

Aaltonen¹,

Keränen²,

Carpelan-Holmström³

et al. 2016

Dig Surg

View full text Add to dashboard Cite

show abstract

“…1 The independent blind reporting provides strength to the study. We have several points for the author's consideration.…”

mentioning

confidence: 99%

Letter of Response to Article: Preoperative Magnetic Resonance Enterography in Predicting Findings and Optimizing Surgical Approach in Crohn’s Disease

Morar

Bagnall

Faiz

2014

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

Perioperative optimization of Crohn's disease

Lin

Chen

et al. 2022

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Crohn's disease (CD) is a chronic inflammatory disease mainly affecting the gastrointestinal tract. With the increased availability of modalities in the last two decades, the treatment of CD has advanced remarkably. Although medical treatment is the mainstay of therapy, most patients require surgery during the course of their illness, especially those who experience complications. Nutritional optimization and ERAS implementation are crucial for patients with CD who require surgical intervention to reduce postoperative complications. The increased surgical risk was found to be associated with the use of corticosteroids, but the association of surgical risk with immunomodulators, biologic therapy, such as anti‐TNF mediations, anti‐integrin medications, and anti‐IL 12/23 was low in certainty. Decisions about preoperative medication must be made on an individual case‐dependent basis. Preoperative imaging studies can assist in the planning of appropriate surgical strategies and approaches. However, patients must be informed of any alterations to their treatment. In summary, the management of perioperative medications and surgery‐related decision‐making should be individualized and patient‐centered based on a multidisciplinary approach.

show abstract

Preoperative Magnetic Resonance Enterography in Predicting Findings and Optimizing Surgical Approach in Crohn's Disease

Abstract: Surgical strategy and approach are correctly predicted by magnetic resonance enterography in the majority of patients with complicated Crohn's disease.

Cited by 29 publications

References 18 publications

Intra-Abdominal Adhesions Make the Interpretation of Magnetic Resonance Enterography in Crohn's Disease More Difficult

Intra-Abdominal Adhesions Make the Interpretation of Magnetic Resonance Enterography in Crohn's Disease More Difficult

Letter of Response to Article: Preoperative Magnetic Resonance Enterography in Predicting Findings and Optimizing Surgical Approach in Crohn’s Disease

Perioperative optimization of Crohn's disease

Contact Info

Product

Resources

About