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Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease

AIMS: Wireless capsule endoscopy (WCE) and magnetic resonance enterography (MRE) are increasingly utilized to evaluate the small bowel (SB) in Crohn’s disease (CD). The primary aims were to compare the ability of WCE and MRE to detect SB inflammation in children with newly diagnosed CD, and in the t...

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Autores principales: Prichard, David O, Hamilton, Zachary, Savage, Thomas, Smyth, Matthew, Penner, Carlie, Lakhani, Alam, Carroll, Matthew W, Al Sarkhy, Ahmed, Lemberg, Daniel A, Enns, Robert, Jamieson, Douglas, Jacobson, Kevan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678730/
https://www.ncbi.nlm.nih.gov/pubmed/33241181
http://dx.doi.org/10.1093/jcag/gwz028
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author Prichard, David O
Hamilton, Zachary
Savage, Thomas
Smyth, Matthew
Penner, Carlie
Lakhani, Alam
Carroll, Matthew W
Al Sarkhy, Ahmed
Lemberg, Daniel A
Enns, Robert
Jamieson, Douglas
Jacobson, Kevan
author_facet Prichard, David O
Hamilton, Zachary
Savage, Thomas
Smyth, Matthew
Penner, Carlie
Lakhani, Alam
Carroll, Matthew W
Al Sarkhy, Ahmed
Lemberg, Daniel A
Enns, Robert
Jamieson, Douglas
Jacobson, Kevan
author_sort Prichard, David O
collection PubMed
description AIMS: Wireless capsule endoscopy (WCE) and magnetic resonance enterography (MRE) are increasingly utilized to evaluate the small bowel (SB) in Crohn’s disease (CD). The primary aims were to compare the ability of WCE and MRE to detect SB inflammation in children with newly diagnosed CD, and in the terminal ileum (TI) to compare them to ileo-colonoscopy. Secondary aims were to compare diagnostic accuracy of WCE and MRE and changes in Paris classification after each study. METHODS: Patients (10 to 17 years of age) requiring ileo-colonoscopy for suspected CD were invited to participate. Only patients with endoscopic/histologic evidence of CD underwent MRE and WCE. SB inflammation and extent were documented and comparative analyses performed. RESULTS: Of 38 initially recruited subjects, 20 completed the study. WCE and MRE were similarly sensitive in identifying active TI inflammation (16 [80%] versus 12 [60%]) and any SB inflammation (17 [85%] versus 16 [80%]). However, WCE detected more extensive SB disease than MRE with active inflammation throughout the SB in 15 [75%] versus 1 [5%] patient (P < 0.001). Moreover, WCE was more likely to detect proximal SB disease (jejunum and ileum) compared to MRE (85% versus 50%, P = 0.04). Overall, the Paris classification changed in 65% and 85% of patients following MRE and WCE, respectively. CONCLUSIONS: WCE is as sensitive as MRE for identifying active TI inflammation, but appears more sensitive in identifying more proximal SB inflammation. In the absence of concern regarding stricturing or extra-luminal disease WCE can be considered for the evaluation of suspected SB CD.
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spelling pubmed-76787302020-11-24 Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease Prichard, David O Hamilton, Zachary Savage, Thomas Smyth, Matthew Penner, Carlie Lakhani, Alam Carroll, Matthew W Al Sarkhy, Ahmed Lemberg, Daniel A Enns, Robert Jamieson, Douglas Jacobson, Kevan J Can Assoc Gastroenterol Original Articles AIMS: Wireless capsule endoscopy (WCE) and magnetic resonance enterography (MRE) are increasingly utilized to evaluate the small bowel (SB) in Crohn’s disease (CD). The primary aims were to compare the ability of WCE and MRE to detect SB inflammation in children with newly diagnosed CD, and in the terminal ileum (TI) to compare them to ileo-colonoscopy. Secondary aims were to compare diagnostic accuracy of WCE and MRE and changes in Paris classification after each study. METHODS: Patients (10 to 17 years of age) requiring ileo-colonoscopy for suspected CD were invited to participate. Only patients with endoscopic/histologic evidence of CD underwent MRE and WCE. SB inflammation and extent were documented and comparative analyses performed. RESULTS: Of 38 initially recruited subjects, 20 completed the study. WCE and MRE were similarly sensitive in identifying active TI inflammation (16 [80%] versus 12 [60%]) and any SB inflammation (17 [85%] versus 16 [80%]). However, WCE detected more extensive SB disease than MRE with active inflammation throughout the SB in 15 [75%] versus 1 [5%] patient (P < 0.001). Moreover, WCE was more likely to detect proximal SB disease (jejunum and ileum) compared to MRE (85% versus 50%, P = 0.04). Overall, the Paris classification changed in 65% and 85% of patients following MRE and WCE, respectively. CONCLUSIONS: WCE is as sensitive as MRE for identifying active TI inflammation, but appears more sensitive in identifying more proximal SB inflammation. In the absence of concern regarding stricturing or extra-luminal disease WCE can be considered for the evaluation of suspected SB CD. Oxford University Press 2019-09-28 /pmc/articles/PMC7678730/ /pubmed/33241181 http://dx.doi.org/10.1093/jcag/gwz028 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Prichard, David O
Hamilton, Zachary
Savage, Thomas
Smyth, Matthew
Penner, Carlie
Lakhani, Alam
Carroll, Matthew W
Al Sarkhy, Ahmed
Lemberg, Daniel A
Enns, Robert
Jamieson, Douglas
Jacobson, Kevan
Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease
title Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease
title_full Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease
title_fullStr Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease
title_full_unstemmed Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease
title_short Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease
title_sort capsule endoscopy complements magnetic resonance enterography and endoscopy in evaluating small bowel crohn’s disease
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678730/
https://www.ncbi.nlm.nih.gov/pubmed/33241181
http://dx.doi.org/10.1093/jcag/gwz028
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