Diagnostic Value of Mr and Ct Enterography in Post-Operative Recurrence of Crohn’S Disease: A Systematic Review and Meta-Analysis Publisher Pubmed

Summary: Spotting Crohn's comeback? A meta-analysis shows CT/MR enterography detects post-op recurrence with 91% sensitivity—wall thickening sensitive, penetrating lesions specific, aiding non-invasive monitoring. #CrohnsDisease #Radiology

Chavoshi M¹ ; Zamani S¹ ; Kolahdoozan S² ; Radmard AR³
Source: Abdominal Radiology Published:2024

Abstract

Post-operative recurrence is a critical issue in the surveillance of Crohn’s disease after ileocecal resection. This meta-analysis aims to assess the diagnostic yield of enterography techniques in post-operative recurrence of Crohn’s disease. A systematic electronic bibliographic databases search was conducted. The inclusion criteria of original articles were: Utilized MR enterography or CT enterography after ileocolonic resection; Documented recurrence by ileo-colonoscopy (Rutgeerts’ score ≥ i2); Provided crude data of diagnostic performance. A random-effect method was used for analysis. Relative risk and diagnostic value of each imaging feature were calculated. Eleven studies (11 populations and 589 patients) were included (4 CTE and 7 MRE with 248 and 341 patients, respectively). The pooled sensitivity and specificity of the enterography were 91% (95% CI: 0.85–0.95) and 75% (95% CI: 0.56–0.87), respectively. The pooled sensitivity and specificity of CTE were 93% (95% CI: 0.87–0.96) and 67% (95% CI: 0.35–0.90), respectively. MRE revealed pooled sensitivity and specificity of 90% (95% CI: 0.78–0.96) and 78% (95% CI: 0.57–0.90), respectively. The inter-study heterogeneity was low for sensitivity (I2 = 29%, p-value = 0.17) and high for specificity (I2 = 85%, p-value < 0.01). Wall enhancement, anastomosis wall thickening, anastomosis stenosis, pre-anastomotic dilatation, penetrating lesion, comb sign, and perivisceral edema were significantly higher in POR patients. Wall thickening and penetrating lesion were the most sensitive (81%) and specific (97%) findings, respectively. MRE and CTE exhibit high sensitivity and acceptable specificity (especially MRE) for detection of recurrence in Crohn’s disease which makes them an effective initial screening tool and reserves ileo-colonoscopy for those patients with inconclusive enterography results. Graphical Abstract: (Figure presented.) © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.