Diagnosis of small bowel Crohn's disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis
Open Access
- 28 May 2005
- Vol. 54 (12), 1721-1727
- https://doi.org/10.1136/gut.2005.069427
Abstract
Background and aims: The diagnostic yield of capsule endoscopy (CE) compared with magnetic resonance imaging (MRI) in small bowel Crohn’s disease is not well established. We prospectively investigated CE, MRI, and double contrast fluoroscopy in patients with suspected small bowel Crohn’s disease. Methods: Fifty two consecutive patients (39 females, 13 males) were investigated by MRI, fluoroscopy and—if bowel obstruction could be excluded—by CE. In 25, Crohn’s disease was newly suspected while the diagnosis of Crohn’s disease (non-small bowel) had been previously established in 27. Results: Small bowel Crohn’s disease was diagnosed in 41 of 52 patients (79%). CE was not accomplished in 14 patients due to bowel strictures. Of the remaining 27 patients, CE, MRI, and fluoroscopy detected small bowel Crohn’s disease in 25 (93%), 21 (78%), and 7 (of 21; 33%) cases, respectively. CE was the only diagnostic tool in four patients. CE was slightly more sensitive than MRI (12 v 10 of 13 in suspected Crohn’s disease and 13 v 11 of 14 in established Crohn’s disease). MRI detected inflammatory conglomerates and enteric fistulae in three and two cases, respectively. Conclusion: CE and MRI are complementary methods for diagnosing small bowel Crohn’s disease. CE is capable of detecting limited mucosal lesions that may be missed by MRI, but awareness of bowel obstruction is mandatory. In contrast, MRI is helpful in identifying transmural Crohn’s disease and extraluminal lesions, and may exclude strictures.Keywords
This publication has 28 references indexed in Scilit:
- Simethicone for small bowel preparation for capsule endoscopy: a systematic, single-blinded, controlled studyGastrointestinal Endoscopy, 2004
- Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel diseaseClinical Gastroenterology and Hepatology, 2004
- Capsule Endoscopy in Patients with Suspected Crohn’s Disease and Negative EndoscopyEndoscopy, 2003
- Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn's diseaseEuropean Journal of Gastroenterology & Hepatology, 2003
- Diagnosing small bowel Crohn's disease with wireless capsule endoscopyGut, 2003
- The First Prospective Controlled Trial Comparing Wireless Capsule Endoscopy with Push Enteroscopy in Chronic Gastrointestinal BleedingEndoscopy, 2002
- Intraoperative enteroscopy detects more lesions but is not predictive of postoperative recurrence in Crohn’s diseaseSurgical Endoscopy, 2001
- Enteroclysis or small bowel follow-through in Crohn's disease?Gastroenterology, 1998
- Intraoperative enteroscopy in Crohn's diseaseBritish Journal of Surgery, 1993
- A modified technique for the double-contrast small bowel enemaGastrointestinal Radiology, 1978