摘要
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, fluorosco py and if bowel obstruction could be excluded-by CE. In 25, Crohn‘s disease wa s 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 di agnosed 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 dete cted small bowel Crohn‘s disease in 25 (93%), 21 (78%), and 7 (of 21; 33%) c ases, respectively. CE was the only diagnostic tool in four patients. CE was sli ghtly more sensitive than MRI (12 v 10 of 13 in suspected Crohn‘s disease and 1 3 v 11 of 14 in established Crohn‘s disease). MRI detected inflammatory conglom erates 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, bu t awareness of bowel obstruction is mandatory. In contrast, MRI is helpful in id entifying transmural Crohn‘s disease and extraluminal lesions, and may exclude strictures.
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, fluorosco py and if bowel obstruction could be excluded-by CE. In 25, Crohn‘s disease wa s 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 di agnosed 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 dete cted small bowel Crohn‘s disease in 25 (93%), 21 (78%), and 7 (of 21; 33%) c ases, respectively. CE was the only diagnostic tool in four patients. CE was sli ghtly more sensitive than MRI (12 v 10 of 13 in suspected Crohn‘s disease and 1 3 v 11 of 14 in established Crohn‘s disease). MRI detected inflammatory conglom erates 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, bu t awareness of bowel obstruction is mandatory. In contrast, MRI is helpful in id entifying transmural Crohn‘s disease and extraluminal lesions, and may exclude strictures.
