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Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease

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Abstract

Background and aims

Small bowel MR enteroclysis and wireless capsule endoscopy (WCE) are new diagnostic tools for the investigation of the small bowel. The aim of this study was to compare the diagnostic yield of WCE with MR enteroclysis in the detection of small bowel pathologies.

Methods

A total of 36 patients were included in the study. Indications for imaging of the small bowel were proven or suspected small bowel Crohn’s disease (CD; n=18), obscure gastrointestinal (GI) bleeding (n=14) and tumour surveillance (n=4).

Results

In patients with Crohn’s disease WCE detected significantly more inflammatory lesions in the first two segments of the small bowel compared with MR enteroclysis (12 patients vs. 1 patient, p=0.016). In 5 out of 14 (36%) patients with GI bleeding, angiodysplasia was detected as a possible bleeding source. Three of these patients had active bleeding sites detected by WCE. One patient had scattered inflammation of the mucosa. MR enteroclysis did not reveal any intestinal abnormalities in this patient group. MR enteroclysis provided extraintestinal pathologies in 10 out of 36 (28%) patients.

Conclusion

In patients with Crohn’s disease WCE revealed significantly more inflammatory lesions in the proximal and middle part of the small bowel in comparison to MR enteroclysis, whereas in patients with obscure GI bleeding WCE was superior to MR enteroclysis.

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References

  1. Sellink JL (1974) Radiologic examination of the small intestine by duodenal intubation. Acta Radiol Diagn (Stockh) 15:318–332

    Google Scholar 

  2. Ott DJ, Chen YM, Gelfand DW, Van Swearingen F, Munitz HA (1985) Detailed per-oral small bowel examination vs. enteroclysis. II. Radiographic accuracy. Radiology 155:31–34

    Google Scholar 

  3. Schreyer AG, Geissler A, Albrich H, Scholmerich J, Feuerbach S, Rogler G, Volk M, Herfarth H (2004) Abdominal MRI after enteroclysis or with oral contrast in patients with suspected or proven Crohn’s disease. Clin Gastroenterol Hepatol 2:491–497

    Google Scholar 

  4. Rieber A, Wruk D, Potthast S, Nussle K, Reinshagen M, Adler G, Brambs HJ (2000) Diagnostic imaging in Crohn’s disease: comparison of magnetic resonance imaging and conventional imaging methods. Int J Colorectal Dis 15:176–181

    Google Scholar 

  5. Turetschek K, Schober E, Wunderbaldinger P, Bernhard C, Schima W, Puespoek A, Vogelsang H, Moeschl P, Mostbeck G (2002) Findings at helical CT-enteroclysis in symptomatic patients with Crohn disease: correlation with endoscopic and surgical findings. J Comput Assist Tomogr 26:488–492

    Google Scholar 

  6. Hassan C, Cerro P, Zullo A, Spina C, Morini S (2003) Computed tomography enteroclysis in comparison with ileoscopy in patients with Crohn’s disease. Int J Colorectal Dis 18:121–125

    Google Scholar 

  7. Iddan G, Meron G, Glukhovsky A, Swain P (2000) Wireless capsule endoscopy. Nature 405:417

    Google Scholar 

  8. Appleyard M, Fireman Z, Glukhovsky A, Jacob H, Shreiver R, Kadirkamanathan S, Lavy A, Lewkowicz S, Scapa E, Shofti R, Swain P, Zaretsky A (2000) A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small-bowel lesions. Gastroenterology 119:1431–1438

    Google Scholar 

  9. Costamagna G, Shah SK, Riccioni ME, Foschia F, Mutignani M, Perri V, Vecchioli A, Brizi MG, Picciocchi A, Marano P (2002) A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. Gastroenterology 123:999–1005

    Google Scholar 

  10. Eliakim R, Fischer D, Suissa A, Yassin K, Katz D, Guttman N, Migdal M (2003) Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn’s disease. Eur J Gastroenterol Hepatol 15:363–367

    Google Scholar 

  11. Fireman Z, Mahajna E, Broide E, Shapiro M, Fich L, Sternberg A, Kopelman Y, Scapa E (2003) Diagnosing small bowel Crohn’s disease with wireless capsule endoscopy. Gut 52:390–392

    Google Scholar 

  12. Mow WS, Lo SK, Targan SR, Dubinsky MC, Treyzon L, Abreu-Martin MT, Papadakis KA, Vasiliauskas EA, Voderholzer WA, Ortner M, Rogalla P, Beinholzl J, Lochs H (2004) Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease. Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis. Clin Gastroenterol Hepatol 2:31–40

    Google Scholar 

  13. Voderholzer WA, Ortner M, Rogalla P, Beinholzl J, Lochs H (2003) Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis. Endoscopy 35:1009–1014

    Google Scholar 

  14. Ell C, Remke S, May A, Helou L, Henrich R, Mayer G (2002) The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy 34:685–689

    Google Scholar 

  15. Liangpunsakul S, Chadalawada V, Rex DK, Maglinte D, Lappas J (2003) Wireless capsule endoscopy detects small bowel ulcers in patients with normal results from state of the art enteroclysis. Am J Gastroenterol 98:1295–1298

    Google Scholar 

  16. Rieber A, Aschoff A, Nussle K, Wruk D, Tomczak R, Reinshagen M, Adler G, Brambs HJ (2000) MRI in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis. Eur Radiol 10:1377–1382

    Google Scholar 

  17. Hilfiker PR, Weishaupt D, Kacl GM, Hetzer FH, Griff MD, Ruehm SG, Debatin JF (1999) Comparison of three dimensional magnetic resonance imaging in conjunction with a blood pool contrast agent and nuclear scintigraphy for the detection of experimentally induced gastrointestinal bleeding. Gut 45:581–587

    Google Scholar 

  18. Schreyer AG, Golder S, Seitz J, Herfarth H (2003) New diagnostic avenues in inflammatory bowel diseases. Capsule endoscopy, magnetic resonance imaging and virtual enteroscopy. Dig Dis 21:129–137

    Google Scholar 

  19. De Mascarenhas-Saraiva MN, da Silva Araujo Lopes LM (2003) Small-bowel tumors diagnosed by wireless capsule endoscopy: report of five cases. Endoscopy 35:865–868

    Google Scholar 

  20. Schulmann K, Schmiegel W (2004) Capsule endoscopy for small bowel surveillance in hereditary intestinal polyposis and non-polyposis syndromes. Gastrointest Endosc Clin N Am 14:149–158

    Google Scholar 

  21. Barkay O, Alon-Baron L, Shemesh E, Arber N, Costamagna G, Shah SK, Riccioni ME, Foschia F, Mutignani M, Perri V, Vecchioli A, Brizi MG, Picciocchi A, Marano P (2004) Endoscopically assisted wireless capsule endoscopy in a patient with familial adenomatous polyposis after total proctocolectomy and continent ileostomy: a prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. Isr Med Assoc J 6:251–252

    Google Scholar 

  22. Wold PB, Fletcher JG, Johnson CD, Sandborn WJ (2003) Assessment of small bowel Crohn disease: noninvasive peroral CT enterography compared with other imaging methods and endoscopy—feasibility study. Radiology 229:275–281

    Google Scholar 

  23. Lo SK (2004) Capsule endoscopy in the diagnosis and management of inflammatory bowel disease. Gastrointest Endosc Clin N Am 14:179–193

    Google Scholar 

  24. Hanauer SB, Stromberg U (2004) Oral pentasa in the treatment of active Crohn’s disease: a meta-analysis of double-blind, placebo-controlled trials. Clin Gastroenterol Hepatol 2:379–388

    Google Scholar 

  25. Feagan BG (2004) 5-ASA therapy for active Crohn’s disease: old friends, old data, and a new conclusion. Clin Gastroenterol Hepatol 2:376–378

    Google Scholar 

  26. Herfarth H, Gross V, Andus T, Caesar I, Vogelsang H, Adler G, Malchow H, Petri A, Gierend M, Scholmerich J (2003) Analysis of the therapeutic efficacy of different doses of budesonide in patients with active Crohn’s ileocolitis depending on disease activity and localization. Int J Colorectal Dis 19:147–152

    Google Scholar 

  27. Sandborn WJ, Feagan BG (2003) Review article: mild to moderate Crohn’s disease—defining the basis for a new treatment algorithm. Aliment Pharmacol Ther 18:263–277

    Google Scholar 

  28. Modigliani R (1990) Endoscopic severity index for Crohn’s disease. Gastrointest Endosc 36:637

    Google Scholar 

  29. Modigliani R, Mary JY, Simon JF, Cortot A, Soule JC, Gendre JP, Rene E (1990) Clinical, biological, and endoscopic picture of attacks of Crohn’s disease. Evolution on prednisolone. Groupe d’Etude Therapeutique des Affections Inflammatoires Digestives. Gastroenterology 98:811–818

    Google Scholar 

  30. McLeod RS, Wolff BG, Steinhart AH, Carryer PW, O’Rourke K, Andrews DF, Blair JE, Cangemi JR, Cohen Z, Cullen JB, Chaytor RG, Greenberg GR, Jaffer NM, Jeejeebhoy KN, MacCarty RL, Ready RL, Weiland LH (1997) Risk and significance of endoscopic/radiological evidence of recurrent Crohn’s disease. Gastroenterology 113:1823–1827

    Google Scholar 

  31. Rutgeerts P (2003) Modern therapy for inflammatory bowel disease. Scand J Gastroenterol Suppl (237):30–33?

    Google Scholar 

  32. Zuckerman GR, Prakash C, Askin MP, Lewis BS (2000) AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology 118:201–221

    Google Scholar 

  33. Chan FP, Chhor CM (2003) Active lower gastrointestinal hemorrhage diagnosed by magnetic resonance angiography: case report. Abdom Imaging 28:637–639

    Google Scholar 

  34. Anderson CM (2002) GI magnetic resonance angiography. Gastrointest Endosc 55:S42–S48

    Google Scholar 

  35. Rossini FP, Risio M, Pennazio M (1999) Small bowel tumors and polyposis syndromes. Gastrointest Endosc Clin N Am 9:93–114

    Google Scholar 

  36. Maglinte DDT, Siegelman ES, Kelvin FM (2000) MR enteroclysis: the future of small-bowel imaging? Radiology 215:639–641

    Google Scholar 

  37. Bender GN, Maglinte DD, Kloppel VR, Timmons JH (1999) CT enteroclysis: a superfluous diagnostic procedure or valuable when investigating small-bowel disease? Am J Roentgenol 172:373–378

    Google Scholar 

  38. De Franco A, Celi G, Restaino G, Foschi R, Vecchioli A, Marano P, Papanikolaou N, Prassopoulos P, Grammatikakis I, Maris T, Gourtsoyiannis NC, Rieber A, Aschoff A, Nussle K, Wruk D, Tomczak R, Reinshagen M, Adler G, Brambs HJ (2002) Imaging of small bowel tumors: technical challenges and clinical applications of magnetic resonance enteroclysis in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis. Rays 27:35–50

    Google Scholar 

  39. Bader TR, Semelka RC, Chiu VC, Armao DM, Woosley JT (2001) MRI of carcinoid tumors: spectrum of appearances in the gastrointestinal tract and liver. J Magn Reson Imaging 14:261–269

    Google Scholar 

  40. Horton KM, Kamel I, Hofmann L, Fishman EK (2004) Carcinoid tumors of the small bowel: a multitechnique imaging approach. Am J Roentgenol 182:559–567

    Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine I, University of Regensburg, 93042, Regensburg, Germany

    Stefan K. Gölder, Esther Endlicher, Jürgen Schölmerich, Frank Kullmann, Gerhard Rogler & Hans Herfarth

  2. Department of Radiology, University of Regensburg, 93042, Regensburg, Germany

    Andreas G. Schreyer, Stefan Feuerbach & Johannes Seitz

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  1. Stefan K. Gölder
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  2. Andreas G. Schreyer
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  3. Esther Endlicher
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  4. Stefan Feuerbach
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  5. Jürgen Schölmerich
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  7. Johannes Seitz
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  8. Gerhard Rogler
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  9. Hans Herfarth
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Correspondence to Hans Herfarth.

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Gölder, S.K., Schreyer, A.G., Endlicher, E. et al. Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease. Int J Colorectal Dis 21, 97–104 (2006). https://doi.org/10.1007/s00384-005-0755-0

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  • DOI: https://doi.org/10.1007/s00384-005-0755-0

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