MRI is a low-dose option for diagnosing Crohn's study finds

MRI could replace CT as a low-dose option when diagnosing Crohn’s Disease in the small bowel, according to a study published in Academic Radiology.

Crohn’s disease affects between 400,000 and 600,000 individuals in North America, mostly in the small intestine. CT has been the traditional first-line imaging option when diagnosing the gastrointestinal condition, but it requires a fairly large radiation dose while MRI diagnostic exams are non-ionizing.

Previous studies have compared sensitivity and specificity of CT and MRI but the results have varied, prompting researchers from the First Affiliated Hospital of the University of South China to conduct a meta-analysis to determine any differences. The authors found 21 studies involving over 900 patients after trawling major research databases for research that fit their criteria, compiling the data to determine diagnostic odds ratios.

They determined CT had a sensitivity and specificity of 0.87 and 0.91, respectively. MRI almost exactly matched those figures, coming in at a sensitivity of 0.86 and a specificity of 0.93, leading the authors to conclude the modalities have comparable accuracy to detect small-bowel Crohn’s Disease.

However, they did find differences between individual exams. CT enterography and enteroclysis were found to be more specific than their MR counterparts, but a recent 290-patient study found comparable diagnostic accuracy in clinical applications.

“No significant difference was detected for diagnostic performances for MR enteroclysis, MR enterography, and CT enterography,” wrote Liu et al. “These results indicated that although each technique has its own unique advantages and limitations in clinical practice, these modalities are equally highly accurate techniques in assessing SB CD in the present meta-analysis.”

These findings could reduce patient dose in the diagnosis of Crohn’s disease, according to the authors.

“MRI has the potential to substitute CT as the first-line radiation-free imaging modality in certain scenarios,” wrote Liu et al. “This is especially useful in assessing pediatric patients.”