Endoscopy and MR enteroclysis: Equivalent tools in predicting clinical recurrence in patients with Crohn's disease after ileocolic resection

Stavroula Koilakou, Johannes Sailer, Philipp Peloschek, Arnulf Ferlitsch, Harald Vogelsang, Wolfgang Miehsler, Joel Fletcher, Karl Turetschek, Wolfgang Schima, Walter Reinisch

Research output: Contribution to journalArticlepeer-review

80 Scopus citations

Abstract

Background: Ileocolonoscopy poses the gold standard in the evaluation of postoperative recurrence of Crohn's disease (CD) at the site of ileocolonic anastomosis. Magnetic resonance enteroclysis (MRE) on the other hand is a promising technique for small bowel imaging. The aim was to compare MRE and ileocolonoscopy for predicting clinical recurrence in CD patients who have undergone ileocolonic resection. Methods: We included 29 patients in the study. The median time since index operation was 35 months and between ileocolonoscopy and MRE was 3 days. Patients were followed up for a maximum of 2 years unless clinical recurrence occurred earlier. Endoscopic findings were evaluated on a 5-grade scale (i0-i4), whereas MRE findings on the neoterminal ileum and anastomosis were assessed according to a previously validated 4-grade scale MR score (MR0-MR3). Results: By classifying patients into subgroups of endoscopic severity of postoperative recurrence using as a threshold an endoscopic score of i3, we found that 10% of patients in the i0 to i2 group had a clinical recurrence during the 2-year follow-up period as compared to 52.6% of subjects with i3 to i4 (P = 0.043). The corresponding clinical exacerbation rates in the subgroups based on MRE severity assessment were 12.5% for MR0 to MR1 and 50% for MR2 to MR3 (P = 0.09). Conclusions: Our data suggest that colonoscopy and MR enteroclysis are of similar value to predict the risk of clinical recurrence in postoperative patients with Crohn's disease.

Original languageEnglish (US)
Pages (from-to)198-203
Number of pages6
JournalInflammatory bowel diseases
Volume16
Issue number2
DOIs
StatePublished - Jan 18 2010

Keywords

  • Clinical relapse
  • Crohn's disease
  • Ileocolonoscopy
  • Magnetic resonance enteroclysis
  • Postoperative

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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