Backwash ileitis in ulcerative colitis: Are there MR enterographic features that distinguish it from Crohn disease?

To reveal the MR enterography (MRE) findings that distinguish backwash ileitis (BWI) from terminal ileitis due to Crohn's disease (CD) and to determine the usability of barium studies manifestations (ileocecal valve (ICV) gaping, terminal ileum dilatation) in MRE for the diagnosis of BWI in ulc...

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Veröffentlicht in:European journal of radiology 2019-01, Vol.110, p.212-218
Hauptverfasser: Erden, Ayse, Kuru Öz, Diğdem, Gürsoy Çoruh, Ayşegül, Erden, İlhan, Özalp Ateş, Funda Seher, Törüner, Murat
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container_title European journal of radiology
container_volume 110
creator Erden, Ayse
Kuru Öz, Diğdem
Gürsoy Çoruh, Ayşegül
Erden, İlhan
Özalp Ateş, Funda Seher
Törüner, Murat
description To reveal the MR enterography (MRE) findings that distinguish backwash ileitis (BWI) from terminal ileitis due to Crohn's disease (CD) and to determine the usability of barium studies manifestations (ileocecal valve (ICV) gaping, terminal ileum dilatation) in MRE for the diagnosis of BWI in ulcerative colitis (UC) patients by pointing at the diagnostic performance of these imaging findings. The study population consisted of patients who were diagnosed as ulcerative colitis (UC), and underwent 1.5 T MRI between August 2011 and November 2017 to rule out small bowel involvement. The matched controls were comprised of Crohn’s patients examined at the same period. Ileocolonoscopic/ histopathologic findings were accepted as reference standard. Mural/extramural changes in bowel segments, ileocecal valve (ICV) gaping, terminal ileum dilatation, restricted diffusion and anatomical extent of involvement were evaluated. In UC patients, the association between ICV gaping and terminal ileum dilatation and BWI was assessed by χ2 test. The diagnostic accuracy of these two findings in BWI was determined. Sixty patients were included in the study (30 UC; 30 CD; mean age, 43 years in both groups). Ileocecal valve gaping and terminal ileum dilatation were significantly more frequent among BWI patients (p 
doi_str_mv 10.1016/j.ejrad.2018.11.027
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The study population consisted of patients who were diagnosed as ulcerative colitis (UC), and underwent 1.5 T MRI between August 2011 and November 2017 to rule out small bowel involvement. The matched controls were comprised of Crohn’s patients examined at the same period. Ileocolonoscopic/ histopathologic findings were accepted as reference standard. Mural/extramural changes in bowel segments, ileocecal valve (ICV) gaping, terminal ileum dilatation, restricted diffusion and anatomical extent of involvement were evaluated. In UC patients, the association between ICV gaping and terminal ileum dilatation and BWI was assessed by χ2 test. The diagnostic accuracy of these two findings in BWI was determined. Sixty patients were included in the study (30 UC; 30 CD; mean age, 43 years in both groups). Ileocecal valve gaping and terminal ileum dilatation were significantly more frequent among BWI patients (p &lt; 0.001) in UC. Patients with BWI showed a higher rate of pancolitis (88.9%). Median terminal ileum wall thickness was found to be significantly greater in patients with CD (p &lt; 0.001). In patients with definite diagnosis of UC, ileocecal valve gaping and terminal ileum dilatation suggest the development of BWI. 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The study population consisted of patients who were diagnosed as ulcerative colitis (UC), and underwent 1.5 T MRI between August 2011 and November 2017 to rule out small bowel involvement. The matched controls were comprised of Crohn’s patients examined at the same period. Ileocolonoscopic/ histopathologic findings were accepted as reference standard. Mural/extramural changes in bowel segments, ileocecal valve (ICV) gaping, terminal ileum dilatation, restricted diffusion and anatomical extent of involvement were evaluated. In UC patients, the association between ICV gaping and terminal ileum dilatation and BWI was assessed by χ2 test. The diagnostic accuracy of these two findings in BWI was determined. Sixty patients were included in the study (30 UC; 30 CD; mean age, 43 years in both groups). Ileocecal valve gaping and terminal ileum dilatation were significantly more frequent among BWI patients (p &lt; 0.001) in UC. Patients with BWI showed a higher rate of pancolitis (88.9%). Median terminal ileum wall thickness was found to be significantly greater in patients with CD (p &lt; 0.001). In patients with definite diagnosis of UC, ileocecal valve gaping and terminal ileum dilatation suggest the development of BWI. However, these findings cannot be use to differentiate cause of terminal ileitis in patients with unconfirmed diagnosis and do not give reliable information about the causative factor of ileitis.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Backwash ileitis</subject><subject>Colitis, Ulcerative - complications</subject><subject>Colitis, Ulcerative - diagnostic imaging</subject><subject>Crohn Disease - diagnostic imaging</subject><subject>Crohn Disease - pathology</subject><subject>Crohn's disease</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Humans</subject><subject>Ileitis - complications</subject><subject>Ileitis - diagnostic imaging</subject><subject>Ileitis - pathology</subject><subject>Ileum - diagnostic imaging</subject><subject>Ileum - pathology</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>MR enterography</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Ulcerative colitis</subject><subject>Young Adult</subject><issn>0720-048X</issn><issn>1872-7727</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kFtLxDAQhYMo7nr5BYLk0ZfWXNomFUR08QYrgij4FrLJ1M3abdckVfz3tq766MsMzJxzhvkQOqAkpYQWx4sUFl7blBEqU0pTwsQGGlMpWCIEE5toTAQjCcnk8wjthLAghORZybbRiJO8LGXBxihcaPP6ocMcuxpcdAG7Bne1Aa-jewds2nqYnuBzDzjOoa93DxiaCL598Xo1dwZXoGPnIfR7HbF1IbrmpXNDZsSVb5d44tt5M2xABzjbQ1uVrgPs__Rd9HR1-Ti5Sab317eT82lieF7GJDMkn2kuM9AVVDnLCiEFoSArVlbSEl3ajIrCCE24nfEeiSyAA82sZJwZznfR0Tp35du3DkJUSxcM1LVuoO2CYrRgQogyL3opX0uNb0PwUKmVd0vtPxUlaqCtFuqbthpoK0pVT7t3Hf4c6GZLsH-eX7y94HQtgP7NdwdeBeOgMWCdBxOVbd2_B74AimSSqw</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>Erden, Ayse</creator><creator>Kuru Öz, Diğdem</creator><creator>Gürsoy Çoruh, Ayşegül</creator><creator>Erden, İlhan</creator><creator>Özalp Ateş, Funda Seher</creator><creator>Törüner, Murat</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201901</creationdate><title>Backwash ileitis in ulcerative colitis: Are there MR enterographic features that distinguish it from Crohn disease?</title><author>Erden, Ayse ; Kuru Öz, Diğdem ; Gürsoy Çoruh, Ayşegül ; Erden, İlhan ; Özalp Ateş, Funda Seher ; Törüner, Murat</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-4c05ba384eafef524678701e8f29f8d0a9d4176c7a03db301686e3e14d8232c33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Backwash ileitis</topic><topic>Colitis, Ulcerative - complications</topic><topic>Colitis, Ulcerative - diagnostic imaging</topic><topic>Crohn Disease - diagnostic imaging</topic><topic>Crohn Disease - pathology</topic><topic>Crohn's disease</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Humans</topic><topic>Ileitis - complications</topic><topic>Ileitis - diagnostic imaging</topic><topic>Ileitis - pathology</topic><topic>Ileum - diagnostic imaging</topic><topic>Ileum - pathology</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>MR enterography</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Ulcerative colitis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Erden, Ayse</creatorcontrib><creatorcontrib>Kuru Öz, Diğdem</creatorcontrib><creatorcontrib>Gürsoy Çoruh, Ayşegül</creatorcontrib><creatorcontrib>Erden, İlhan</creatorcontrib><creatorcontrib>Özalp Ateş, Funda Seher</creatorcontrib><creatorcontrib>Törüner, Murat</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Erden, Ayse</au><au>Kuru Öz, Diğdem</au><au>Gürsoy Çoruh, Ayşegül</au><au>Erden, İlhan</au><au>Özalp Ateş, Funda Seher</au><au>Törüner, Murat</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Backwash ileitis in ulcerative colitis: Are there MR enterographic features that distinguish it from Crohn disease?</atitle><jtitle>European journal of radiology</jtitle><addtitle>Eur J Radiol</addtitle><date>2019-01</date><risdate>2019</risdate><volume>110</volume><spage>212</spage><epage>218</epage><pages>212-218</pages><issn>0720-048X</issn><eissn>1872-7727</eissn><abstract>To reveal the MR enterography (MRE) findings that distinguish backwash ileitis (BWI) from terminal ileitis due to Crohn's disease (CD) and to determine the usability of barium studies manifestations (ileocecal valve (ICV) gaping, terminal ileum dilatation) in MRE for the diagnosis of BWI in ulcerative colitis (UC) patients by pointing at the diagnostic performance of these imaging findings. The study population consisted of patients who were diagnosed as ulcerative colitis (UC), and underwent 1.5 T MRI between August 2011 and November 2017 to rule out small bowel involvement. The matched controls were comprised of Crohn’s patients examined at the same period. Ileocolonoscopic/ histopathologic findings were accepted as reference standard. Mural/extramural changes in bowel segments, ileocecal valve (ICV) gaping, terminal ileum dilatation, restricted diffusion and anatomical extent of involvement were evaluated. In UC patients, the association between ICV gaping and terminal ileum dilatation and BWI was assessed by χ2 test. The diagnostic accuracy of these two findings in BWI was determined. Sixty patients were included in the study (30 UC; 30 CD; mean age, 43 years in both groups). Ileocecal valve gaping and terminal ileum dilatation were significantly more frequent among BWI patients (p &lt; 0.001) in UC. Patients with BWI showed a higher rate of pancolitis (88.9%). Median terminal ileum wall thickness was found to be significantly greater in patients with CD (p &lt; 0.001). In patients with definite diagnosis of UC, ileocecal valve gaping and terminal ileum dilatation suggest the development of BWI. However, these findings cannot be use to differentiate cause of terminal ileitis in patients with unconfirmed diagnosis and do not give reliable information about the causative factor of ileitis.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>30599862</pmid><doi>10.1016/j.ejrad.2018.11.027</doi><tpages>7</tpages></addata></record>
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subjects Adolescent
Adult
Aged
Backwash ileitis
Colitis, Ulcerative - complications
Colitis, Ulcerative - diagnostic imaging
Crohn Disease - diagnostic imaging
Crohn Disease - pathology
Crohn's disease
Diagnosis, Differential
Female
Humans
Ileitis - complications
Ileitis - diagnostic imaging
Ileitis - pathology
Ileum - diagnostic imaging
Ileum - pathology
Magnetic Resonance Imaging - methods
Male
Middle Aged
MR enterography
Reproducibility of Results
Retrospective Studies
Ulcerative colitis
Young Adult
title Backwash ileitis in ulcerative colitis: Are there MR enterographic features that distinguish it from Crohn disease?
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