Magnetic resonance evaluation for small bowel strictures in Crohn’s disease: comparison with balloon enteroscopy

Background Magnetic resonance (MR) imaging is the recommended technique for detection of small bowel lesions in Crohn’s disease. We aimed to evaluate the impact of stricture findings obtained by MR imaging on patient outcomes using balloon-assisted enteroscopy (BAE) as a reference. Methods Two hundred Crohn’s disease patients undergoing both MR enterocolonography and BAE were prospectively followed up for at least 1 year. The presence of strictures detected by MR enterocolonography was compared with endoscopic findings. Moreover, the relationship between MR findings and surgery was evaluated. Results The accuracy of MR imaging for detection of small bowel strictures was defined by a sensitivity of 60.6% and a specificity of 93.4%. Major strictures (diameter less than 10 mm or with internal fistula), long strictures (length 10 mm or greater), and prestenotic dilatation were predictors of stricture detection by MR imaging ( P = 0.001, 0.017, and 0.002 respectively). Surgery was performed in 31.6% of patients (18 of 57) in the MR-positive–BAE-positive stricture group and in 10.8% of patients (4 of 37) in the MR-negative–BAE-positive stricture group. Multiple regression analysis showed MR-positive–BAE-positive strictures were an independent risk factor for surgery ( P = 0.002 at 6 months and P