Layered enhancement at magnetic resonance enterography in inflammatory bowel disease: A meta-analysis.
Crohn’s disease
Diagnostic imaging
Fibrosis
Inflammation
Magnetic resonance imaging
Meta-analysis
Sensitivity and specificity
Journal
World journal of gastroenterology
ISSN: 2219-2840
Titre abrégé: World J Gastroenterol
Pays: United States
ID NLM: 100883448
Informations de publication
Date de publication:
21 Aug 2019
21 Aug 2019
Historique:
received:
26
03
2019
revised:
25
06
2019
accepted:
19
07
2019
entrez:
10
9
2019
pubmed:
10
9
2019
medline:
15
2
2020
Statut:
ppublish
Résumé
Documentation of disease activity in patients affected by Crohn's disease (CD) is mandatory in order to manage patients properly. Magnetic resonance imaging (MRI) is considered the reference cross-sectional technique for the assessment of CD activity. Among MRI findings, layered pattern (LP) of contrast enhancement seems to be one of the most significant signs of severe disease activity; however, it has also been associated with chronic disease and mural fibrosis. To systematically evaluate the accuracy of LP of contrast enhancement in the diagnosis of active inflammation in patients with CD. In February 2019, we searched the MEDLINE and Cochrane Central Register of Controlled Trials databases for studies evaluating the diagnostic accuracy of LP of contrast enhancement on MRI for the detection of active inflammation in patients with CD. To be included, studies had to use histopathologic analysis (endoscopy or surgery) as the reference standard. Risk of bias and applicability concerns of the included studies were evaluated by using items from the Quality Assessment for Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Pooled sensitivity and specificity were determined using a bivariate random-effect model. Heterogeneity was quantified by using the Of the 1383 studies identified, five articles were finally selected for quantitative and qualitative synthesis (245 patients, 238 of whom had histopathologically confirmed CD, 144 with active inflammation and 94 with inactive disease). The meta-analysis showed a pooled sensitivity of 49.3% (95%CI: 41%-57.8%; LP on contrast-enhanced MRI is a specific finding to rule out active inflammation in patients with CD. Further studies using a prespecified definition of LP on contrast-enhanced MRI are needed to support our findings.
Sections du résumé
BACKGROUND
BACKGROUND
Documentation of disease activity in patients affected by Crohn's disease (CD) is mandatory in order to manage patients properly. Magnetic resonance imaging (MRI) is considered the reference cross-sectional technique for the assessment of CD activity. Among MRI findings, layered pattern (LP) of contrast enhancement seems to be one of the most significant signs of severe disease activity; however, it has also been associated with chronic disease and mural fibrosis.
AIM
OBJECTIVE
To systematically evaluate the accuracy of LP of contrast enhancement in the diagnosis of active inflammation in patients with CD.
METHODS
METHODS
In February 2019, we searched the MEDLINE and Cochrane Central Register of Controlled Trials databases for studies evaluating the diagnostic accuracy of LP of contrast enhancement on MRI for the detection of active inflammation in patients with CD. To be included, studies had to use histopathologic analysis (endoscopy or surgery) as the reference standard. Risk of bias and applicability concerns of the included studies were evaluated by using items from the Quality Assessment for Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Pooled sensitivity and specificity were determined using a bivariate random-effect model. Heterogeneity was quantified by using the
RESULTS
RESULTS
Of the 1383 studies identified, five articles were finally selected for quantitative and qualitative synthesis (245 patients, 238 of whom had histopathologically confirmed CD, 144 with active inflammation and 94 with inactive disease). The meta-analysis showed a pooled sensitivity of 49.3% (95%CI: 41%-57.8%;
CONCLUSION
CONCLUSIONS
LP on contrast-enhanced MRI is a specific finding to rule out active inflammation in patients with CD. Further studies using a prespecified definition of LP on contrast-enhanced MRI are needed to support our findings.
Identifiants
pubmed: 31496631
doi: 10.3748/wjg.v25.i31.4555
pmc: PMC6710183
doi:
Substances chimiques
Contrast Media
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
4555-4566Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors deny any conflict of interest.
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