MR enterography detects active inflammation in kids with IBD

Last Updated: 2017-10-09

By Megan Brooks

NEW YORK (Reuters Health) - Results of a meta-analysis confirm that magnetic resonance enterography can accurately diagnose active inflammation in pediatric patients with known or suspected inflammatory bowel disease (IBD).

"Magnetic resonance enterography is a noninvasive, radiation-free, and excellent diagnostic modality for children with inflammatory bowel disease," Dr. Young Ah Cho, from the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine in Seoul, Korea, told Reuters Health by email.

"Because children are more sensitive to ionizing radiation and they have to undergo multiple imaging studies during their lifetime to monitor disease activity, MR enterography is the best radiologic imaging modality in the field of pediatric inflammatory bowel disease," Dr. Cho added.

The study was published online October 9 in JAMA Pediatrics.

The analysis included 18 studies evaluating the diagnostic imaging technique for detection of active inflammation in children and adolescents with known or suspected IBD. The studies included a total of 687 patients (mean age, 9.9 to 17.7 years) and ranged in size from 15 to 91 patients.

The summary sensitivity of 83% (95% CI, 75% to 89%), summary specificity of 93% (95% CI, 90% to 95%), and the area under the hierarchical summary receiver operating characteristic curve of 0.95 (95% CI, 0.93 to 0.97) are within the "clinically acceptable range," the researchers report.

Prior studies on the diagnostic performance of MR enterography in adults with Crohn's disease showed a summary sensitivity of 80% to 88% and a summary specificity of 81% to 90%, on par with the current analysis, they note.

In an individual patient analysis, the summary sensitivity was 86% (95% CI, 78% to 91%) and specificity was 91% (95% CI, 82% to 96%). In contrast, in a per-lesion analysis based on seven studies, summary sensitivity was 72% (95% CI, 55% to 84%) and summary specificity was 93% (95% CI, 90% to 95%).

The studies had substantial heterogeneity, and nine of 18 were retrospective, resulting in a high risk of bias in patient selection, the researchers note.

"We hope that our study might be evidence of justification for the application of MR enterography in this population," they conclude in their article.

SOURCE: http://bit.ly/2wJ0n7q

JAMA Pediatr 2017.