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Optimal Assessment of Paediatric IBD With MRI and Barium Follow-through

Giles E et al. – This is the largest series of small bowel MRI in a paediatric population. MRI reports were at least equivalent to barium follow–through (BaFT). MRI had higher sensitivity and, particularly, specificity in detecting terminal ileal pathology. These findings suggest that MRI should become the criterion standard investigation in children with inflammatory bowel disease (IBD) in centres with appropriate expertise, with zero radiation exposure being highly advantageous.

Methods
  • All consecutive patients with a new diagnosis of IBD or requiring reassessment from September 2008 to December 2010 were investigated with both abdominal MRI and BaFT in accordance with a specific local paediatric IBD protocol.
  • The studies were reported by nonblinded radiologists with an interest in gastrointestinal imaging.
  • The reports were compared in conjunction with case note review.

Results
  • Eighty-seven patients underwent both BaFT and MRI abdomen.
  • Thirty-one percent of patients had additional pathology on MRI, not seen on the BaFT.
  • Sixty-seven percent of patients (n=59) had an MRI finding equivalent to BaFT.
  • Using histology as a criterion standard for detecting terminal ileal disease, BaFT had a sensitivity and specificity of 76% and 67%, and MRI had a sensitivity and specificity of 83% and 95%, respectively.
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