Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions.

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Serval ID
serval:BIB_3FBFE18E7F8E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions.
Journal
European Radiology
Author(s)
Schmidt S., Chevallier P., Bessoud B., Meuwly J.Y., Felley C., Meuli R., Schnyder P., Denys A.
ISSN
0938-7994
Publication state
Published
Issued date
11/2007
Peer-reviewed
Oui
Volume
17
Number
11
Pages
2957-2963
Language
english
Notes
Publication types: Journal Article
Abstract
The diagnostic performance of magnetic resonance imaging (MRI) for detection of intestinal fistulas, other than perianal, in patients with known complicated inflammatory bowel conditions (CIBC) was investigated. Our study group consisted of 20 patients (12 women, mean age 43 years) with CIBC, including Crohn's disease (n=13), colonic diverticulitis (n=3), colitis after radiotherapy (n=3) and of postoperative origin (n=1). Eleven surgically proven enteral fistulas were known in ten (50%) of these patients, being of enterovesical (n=3), enterocolic (n=2), enteroenteral (n=2), rectovaginal (n=2), rectovaginovesical (n=1) and of entercutaneous (n=1) localisation. The other ten patients (50%), used as the control group, showed MR features of CIBC, although without any fistulous tract. Multiplanar T1- and T2-weighted sequences had been performed, including gadolinium-enhanced acquisition with fat saturation (1.5 T). MR findings were independently blindly and retrospectively reviewed by three radiologists for the presence and etiology of any fistula, as well as visualization and characterization of the fistulous tract. Results were compared with surgical findings (n=16) and clinical evolution (n=4). Interobserver agreement was calculated. Interobserver agreement kappa for fistula detection was 0.71. Overall sensitivity, specificity and accuracy for fistula detection were 78.6%, 75% and 77.2%, respectively. Sensitivity for fistula characterization was 80.6%, with visualization of the fistulous tract in all cases, whereby T1-weighted gadolinium-enhanced fat-saturated images were considered the most useful sequences. Gadolinium-enhanced MRI is a reliable and reproducible tool for detection of enteral fistulas secondary to inflammatory conditions.
Keywords
Adult, Aged, Female, Gadolinium/pharmacology, Humans, Image Processing, Computer-Assisted, Inflammation, Inflammatory Bowel Diseases/complications, Inflammatory Bowel Diseases/diagnosis, Intestinal Fistula/diagnosis, Intestinal Fistula/pathology, Magnetic Resonance Imaging/instrumentation, Magnetic Resonance Imaging/methods, Male, Middle Aged, Models, Statistical, Reproducibility of Results, Retrospective Studies
Pubmed
Web of science
Open Access
Yes
Create date
11/04/2008 12:52
Last modification date
01/10/2019 7:17
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