Magnetic resonance enterography (MRE) — a non-invasive, radiation-free imaging technique that lets doctors visualize the small intestine — can accurately diagnose active inflammation in children with known or suspected inflammatory bowel disease (IBD), Korean researchers found.
Their study, “Diagnostic Performance of Magnetic Resonance Enterography for Detection of Active Inflammation in Children and Adolescents With Inflammatory Bowel Disease, A Systematic Review and Diagnostic Meta-analysis,” appeared in JAMA Pediatrics.
Physicians usually diagnose IBD using tissue biopsy analysis, but several imaging techniques can provide useful information.
To perform bowel imaging, clinicians can use small-bowel follow-through, abdominal ultrasonography (US), computed tomographic (CT) enterography or capsule endoscopy. However, these methods often lack sensitivity and use radiation. By contrast, MRE combines the benefits of not using radiation with an improved sensitivity to evaluate bowel tissues.
Researchers at South Korea’s University of Ulsan College of Medicine reviewed published clinical data to systematically assess the diagnostic capacity of MRE in children.
“Magnetic resonance enterography has rapidly emerged as the diagnostic imaging modality of choice to identify disease involvement and assess disease activity,” wrote researchers, who found 18 studies comprising 687 patients with known or suspected IBD that met their search criteria.
According to their analysis, MRE ranged from 53 to 100 percent in sensitivity, and from 50 to 100 percent in specificity to detect active inflammation. Still, pooled data analysis demonstrated that these values were within the clinically acceptable range, with 83 percent sensitivity and 93 percent specificity to detect active inflammation in pediatric patients with a 95 percent accuracy rate.
To understand the source of such variability among studies the researchers conducted a detailed analysis of all potential contributing factors, such as study design, population, scanner manufacturer, magnetic field strength,and the reference standard. The only factor shown to significantly change the technique’s sensitivity was the scanner manufacturer.
The investigators concluded that MRE can provide clinical meaningful diagnostic information on active inflammation in children with known or suspected IBD. “We hope that our study might be evidence of justification for the application of MR [magnetic resonance] enterography in this population,” they wrote.
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