Comparison of magnetic resonance enterography and video capsule endoscopy in evaluating small bowel disease

Purpose The goal of this study was to compare magnetic resonance enterography (MIRE) and video capsule endoscopy (VCE) in suspected small bowel disease. Materials and methods Nineteen patients with suspected small bowel disease participated in a prospective clinical comparison of MIRE versus VCE. Both methods were evaluated separately and in conjunction with respect to a combined diagnostic endpoint based on clinical, laboratory, surgical, and histopathological findings. The Fisher's exact and K tests were used in comparing MIRE and VCE. Results Small bowel pathologies were found in 15 out of 19 patients: Crohn's disease (n=5), lymphoma (n=4), lymphangioma (n=1), adenocarcinoma (n=1), postradiation enteropathy 0=1), NSAID-induced enteropathy (n=1), angiodysplasia (n=1), and small bowel adhesions (n=11). VCE and MRE separately and in conjunction showed sensitivities of 92.9, 71.4, and 100% and specificities of 80, 60, and 80% (kappa=0.73 vs. kappa=0.29; P=0.31/kappa=0.85), respectively. In four patients, VCE depicted mucosal pathologies missed by MRE. MRE revealed 19 extraenteric findings in 11 patients as well as small bowel adhesions not detected on VCE (n=1). Conclusion VCE can readily depict and characterize subtle mucosal lesions missed at MIRE, whereas MRE yields additional mural, perienteric, and extraenteric information. Thus, VCE and M RE appear to be complementary methods which, when used in conjunction, may better characterize suspected small bowel disease. Eur J Gastroenterol Hepatol 21:54-65 (C) 2009 Wolters Kluwer Health I Lippincott Williams & Wilkins.