Department of Internal Medicine, Section of Gastroenterology, Hospital of South West Jutland, Esbjerg, Denmark.
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
United European Gastroenterol J. 2022 Nov;10(9):973-982. doi: 10.1002/ueg2.12307. Epub 2022 Sep 7.
Magnetic resonance enterocolonography (MREC) and pan-enteric capsule endoscopy (CE) offers visualization of the entire gastrointestinal tract in a single examination. We examined the diagnostic accuracy of MREC and CE in patients with suspected Crohn's disease (CD).
In a prospective, blinded, multicenter study, we included patients with clinically suspected CD. Patients were examined with MREC, CE, and ileocolonoscopy (IC) within 2 weeks. The primary outcome was per patient sensitivity, specificity, and diagnostic accuracy for ileocolonic CD. IC served as reference standard.
153 patients were included in the study and IC, MREC, and CE was performed in 152, 151, 133 patients, respectively. CD was diagnosed with IC in 59 (39%) patients (terminal ileum (TI) 22, colon 20, TI and colon 17). The sensitivity and specificity for diagnosing ileocolonic CD with MREC was 67.9% (CI 53.7-80.1) and 76.3% (CI 65.2-85.3) (TI 76.9% and 85.6%; colon 27% and 93%) compared to 87.5% (CI 73.2-95.8) and 87.8% (CI 78.2-94.3) with CE (TI 96.6% and 87.5%; colon 75.0% and 93.0%). The sensitivity of CE was superior to that of MREC (p = 0.02). The patient experienced discomfort was equal with CE and MREC and significantly less than with IC.
In patients with suspected CD, CE has a high sensitivity for diagnosing CD in the TI and colon, which is superior to that of MREC. The sensitivity of MREC for diagnosing CD in the colon is poor. CE could be a patient-friendly alternative to IC in selected patients with suspected CD. Registered at ClinicalTrials.gov: NCT03134586.
磁共振肠造影术（MREC）和全肠胶囊内镜（CE）可在一次检查中观察整个胃肠道。我们检查了 MREC 和 CE 在疑似克罗恩病（CD）患者中的诊断准确性。
在一项前瞻性、盲法、多中心研究中，我们纳入了有临床疑似 CD 的患者。患者在 2 周内接受 MREC、CE 和回结肠镜检查（IC）。主要结局为每位患者的回肠 CD 的敏感性、特异性和诊断准确性。IC 作为参考标准。
研究纳入了 153 例患者，分别对 152 例、151 例和 133 例患者进行了 IC、MREC 和 CE 检查。IC 诊断 CD 患者 59 例（39%）（末端回肠 22 例、结肠 20 例、末端回肠和结肠 17 例）。MREC 诊断回肠 CD 的敏感性和特异性分别为 67.9%（53.7-80.1）和 76.3%（65.2-85.3）（末端回肠 76.9%和 85.6%；结肠 27%和 93%），CE 分别为 87.5%（73.2-95.8）和 87.8%（78.2-94.3）（末端回肠 96.6%和 87.5%；结肠 75.0%和 93.0%）。CE 的敏感性优于 MREC（p=0.02）。CE 和 MREC 的患者不适感与 IC 相比明显减少。
在疑似 CD 的患者中，CE 对诊断 TI 和结肠 CD 的敏感性较高，优于 MREC。MREC 对结肠 CD 的敏感性较差。在疑似 CD 的患者中，CE 可能是一种比 IC 更友好的选择。在 ClinicalTrials.gov 注册：NCT03134586。
