Enteroscopic and MR findings of small intestine in Crohn's disease

To assess both active lesions such as ulcers and intestinal damage such as stenosis is important in Crohn's disease (CD). Balloon-assisted enteroscopy (BAE) can assess the small intestinal lesions in detail, but teir prognostic significance is still uncertain. We performed MR enterocolonography (MREC) and BAE in 90 patients and evaluated the prognostic factors for recurrence, hospitalization, and surgery (follow up period median 6 month). In BAE, the CD lesions were detected in the terminal ileum (57.0%) and proximal ileum (60.2%). Multivariable analysis showed that ulcerative lesions in the small intestine were independent factor for recurrence (P=0.0021). Stenotic lesions were independent factor for hospitalization and surgery (P=0.03, P=0.002), however, ulcerative lesions were not independent factor (P=0.556, P=.446). Kaplan Meier method showed that ulcerative lesions were factor for recurrence (P=0.001) but aphthous lesions were not (P=0.199). MREC sensitivities and specificity for ulcerative lesions in the small intestine were 82.4% and 87.6%. MREC sensitivity and specificity for stenotic lesions were 40.8% and 93.7%. It is important to evaluate both active lesions and intestinal damage from the perspective of prognosis in CD. MREC was useful for the detection of active lesions in the small intestine. However, MR imaging was less sensitive for the detection of intestinal damage such as stenoses. Assessment of CD lesions in the small intestine requires the selection of a suitable imaging technique