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- Title
Grading of Crohn's disease activity using CT, MRI, US and scintigraphy: a meta-analysis.
- Authors
Puylaert, C.; Tielbeek, J.; Bipat, S.; Stoker, J.; Puylaert, C A J; Tielbeek, J A W
- Abstract
<bold>Purpose: </bold>To assess the grading of Crohn's disease activity using CT, MRI, US and scintigraphy.<bold>Materials and Methods: </bold>MEDLINE, EMBASE and Cochrane databases were searched (January 1983-March 2014) for studies evaluating CT, MRI, US and scintigraphy in grading Crohn's disease activity compared to endoscopy, biopsies or intraoperative findings. Two independent reviewers assessed the data. Three-by-three tables (none, mild, frank disease) were constructed for all studies, and estimates of accurate, over- and under-grading were calculated/summarized by fixed or random effects models.<bold>Results: </bold>Our search yielded 9356 articles, 19 of which were included. Per-patient data showed accurate grading values for CT, MRI, US and scintigraphy of 86% (95% CI: 75-93%), 84% (95% CI: 67-93%), 44% (95% CI: 28-61%) and 40% (95% CI: 16-70%), respectively. In the per-patient analysis, CT and MRI showed similar accurate grading estimates (P = 0.8). Per-segment data showed accurate grading values for CT and scintigraphy of 87% (95% CI: 77-93%) and 86% (95% CI: 80-91%), respectively. MRI and US showed grading accuracies of 67-82% and 56-75%, respectively.<bold>Conclusions: </bold>CT and MRI showed comparable high accurate grading estimates in the per-patient analysis. Results for US and scintigraphy were inconsistent, and limited data were available.<bold>Key Points: </bold>• CT and MRI have comparable high accuracy in grading Crohn's disease. • Data on US and scintigraphy is inconsistent and limited. • MRI is preferable over CT as it lacks ionizing radiation exposure.
- Subjects
CROHN'S disease; COMPUTED tomography; MAGNETIC resonance imaging; ULTRASONIC imaging; META-analysis; MEDICAL databases; RADIONUCLIDE imaging
- Publication
European Radiology, 2015, Vol 25, Issue 11, p3295
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-015-3737-9