Comparison of the use of wireless capsule endoscopy with magnetic resonance enterography in children with inflammatory bowel disease  

作　　者：Nadia Mazen Hijaz Thomas Mario Attard Jennifer Marie Colombo Neil Joseph Mardis Craig Alan Friesen 

机构地区：[1]Division of Gastroenterology Hepatology and Nutrition, University of Missouri Kansas City, Children’s Mercy Hospital Kansas City

出　　处：《World Journal of Gastroenterology》2019年第28期3808-3822,共15页世界胃肠病学杂志（英文版）

基　　金：Supported by the donation of wireless Small bowel capsule and patency capsules from Giving imaging,Ltd Medtronic company with the funding agreement from Given investigator-initiated study No.13-12

摘　　要：BACKGROUND Magnetic resonance enterography (MRE) and wireless capsule endoscopy (WCE) are equally accepted modalities for noninvasive screening of small bowel involvement (SBI) in children with Crohn’s disease (CD) and indeterminate colitis (IC) albeit there is a paucity of data comparing the two and thereby guiding the clinician in selecting the ideal diagnostic approach. Therefore, the goal of this study is to provide additional evidence for capsule endoscopy role in the evaluation of established Crohn’s disease exacerbation compared to MRE in relation to Pediatric Crohn's Disease Activity Index (PCDAI), and histological indices. AIM To prospectively compare the findings of MRE and WCE and their agreement with PCDAI or histology in children with CD or IC. METHODS Consecutive patients diagnosed with CD and IC were screened for inclusion. After informed consent, patient’s demographic and clinical data was abstracted. The current pediatric disease activity index (PCDAI) and endoscopic findings were included. Patients underwent MRE and WCE including preprocedural patency capsule within a maximum of 7 d of each other. Pathological presence of active small bowel disease in ileal and duodenal biopsies were collected if the endoscopy was performed within 2 mo of the WCE study. Patients who failed to pass the PC were excluded from the study. WCE was read by two different experienced gastroenterologists (Attard TM and Colombo JM) blinded to each other's findings and to the findings on MRE (Mardis NJ). Agreement between WCE reviewers, WCE and MRE findings and concordance between positive PCDAI and SBI based on MRE compared with WCE was computed. RESULTS Forty-five patients were included in the study, 18 withdrew and 27 (20 males and 20 CD), mean age (standard deviation) 13.46 (2.4) years, completed the study protocol. There were no instances of capsule retention. Concordance between gastroenterologist reviewers was excellent for the diagnosis of small intestinal CD with good correlation between the two Lewis scores BACKGROUND Magnetic resonance enterography(MRE) and wireless capsule endoscopy(WCE)are equally accepted modalities for noninvasive screening of small bowel involvement(SBI) in children with Crohn’s disease(CD) and indeterminate colitis(IC) albeit there is a paucity of data comparing the two and thereby guiding the clinician in selecting the ideal diagnostic approach. Therefore, the goal of this study is to provide additional evidence for capsule endoscopy role in the evaluation of established Crohn’s disease exacerbation compared to MRE in relation to Pediatric Crohn’s Disease Activity Index(PCDAI), and histological indices.AIM To prospectively compare the findings of MRE and WCE and their agreement with PCDAI or histology in children with CD or IC.METHODS Consecutive patients diagnosed with CD and IC were screened for inclusion.After informed consent, patient’s demographic and clinical data was abstracted.The current pediatric disease activity index(PCDAI) and endoscopic findings were included. Patients underwent MRE and WCE including preprocedural patency capsule within a maximum of 7 d of each other. Pathological presence of active small bowel disease in ileal and duodenal biopsies were collected if the endoscopy was performed within 2 mo of the WCE study. Patients who failed to pass the PC were excluded from the study. WCE was read by two different experienced gastroenterologists(Attard TM and Colombo JM) blinded to each other’s findings and to the findings on MRE(Mardis NJ). Agreement betweenWCE reviewers, WCE and MRE findings and concordance between positive PCDAI and SBI based on MRE compared with WCE was computed.RESULTS Forty-five patients were included in the study, 18 withdrew and 27(20 males and20 CD), mean age(standard deviation) 13.46(2.4) years, completed the study protocol. There were no instances of capsule retention. Concordance between gastroenterologist reviewers was excellent for the diagnosis of small intestinal CD with good correlation between the two Lewis scores(r = 0.875, P < 0

关 键 词：Crohn’s DISEASE Wireless capsule endoscopy Inflammatory BOWEL DISEASE Magnetic resonance ENTEROGRAPHY SMALL BOWEL involvement SMALL BOWEL DISEASE INDETERMINATE colitis Pediatric CHILDREN 

分 类 号：R[医药卫生]