In this study, the SBFT sensitivity and specificity were 76% and 67%, respectively, whereas MRI demonstrated a greater sensitivity and specificity of 83% and 95%, respectively [22]. Fluoroscopy SBFT, however, does remain an option if problem solving is necessary, such as cutaneous fistula evaluation [21]. Fluoroscopy SBFT may also serve as an alternative to MRI and CT to avoid sedation, particularly in younger children. Crohn Disease-Child gadolinium beyond non-IV contrast-enhanced MRE for detection of active IBD in pediatric patients [29]. Additionally, a study of IV contrast enhanced MRE compared to diffusion-weighted MRE in children and young adults demonstrates that diffusion-weighted imaging in lieu of IV contrast administration provides comparable identification of both inflammatory wall thickening and lesion detection [30]. Another potential indication for MRE is surveillance of asymptomatic Crohn disease patients to assess subclinical disease activity. A study of 34 children and adolescents with asymptomatic Crohn disease patients undergoing MRE surveillance [52] found that several MRE imaging features (mural edema, hyperenhancement, engorged vasa recta, and restricted diffusion) were significant predictors of disease recurrence within 6 months, with sensitivity values of 71% to 86% and specificity values of 68% to 86%. Mural diffusion restriction was found to be the best predictor by multivariate regression and predicted future disease recurrence with an AUC of 0.786. MRE in this variant is also useful for stricture characterization. One study examined 31 bowel segments from pediatric Crohn disease patients who underwent surgical bowel resection and preoperative MRE [17]. Performance of MRE for fibrosis detection was relatively low accuracy (64.9%) because of mixed inflammation and fibrosis within strictures but was higher (83.3%) for fibrotic strictures without superimposed active inflammation.
Crohn Disease Child. In this study, the SBFT sensitivity and specificity were 76% and 67%, respectively, whereas MRI demonstrated a greater sensitivity and specificity of 83% and 95%, respectively [22]. Fluoroscopy SBFT, however, does remain an option if problem solving is necessary, such as cutaneous fistula evaluation [21]. Fluoroscopy SBFT may also serve as an alternative to MRI and CT to avoid sedation, particularly in younger children. Crohn Disease-Child gadolinium beyond non-IV contrast-enhanced MRE for detection of active IBD in pediatric patients [29]. Additionally, a study of IV contrast enhanced MRE compared to diffusion-weighted MRE in children and young adults demonstrates that diffusion-weighted imaging in lieu of IV contrast administration provides comparable identification of both inflammatory wall thickening and lesion detection [30]. Another potential indication for MRE is surveillance of asymptomatic Crohn disease patients to assess subclinical disease activity. A study of 34 children and adolescents with asymptomatic Crohn disease patients undergoing MRE surveillance [52] found that several MRE imaging features (mural edema, hyperenhancement, engorged vasa recta, and restricted diffusion) were significant predictors of disease recurrence within 6 months, with sensitivity values of 71% to 86% and specificity values of 68% to 86%. Mural diffusion restriction was found to be the best predictor by multivariate regression and predicted future disease recurrence with an AUC of 0.786. MRE in this variant is also useful for stricture characterization. One study examined 31 bowel segments from pediatric Crohn disease patients who underwent surgical bowel resection and preoperative MRE [17]. Performance of MRE for fibrosis detection was relatively low accuracy (64.9%) because of mixed inflammation and fibrosis within strictures but was higher (83.3%) for fibrotic strictures without superimposed active inflammation.