MR Enterography in paediatric patients with obscure gastrointestinal bleeding

Emanuele Casciani; Giovanni Di Nardo; Simone Chin; Gabriele Masselli; Elisabetta Polettini; Salvatore Oliva; Denis A Cozzi; Salvatore Cucchiara; Gianfranco Gualdi

doi:10.1016/j.ejrad.2017.05.044

MR Enterography in paediatric patients with obscure gastrointestinal bleeding

Eur J Radiol. 2017 Aug:93:209-216. doi: 10.1016/j.ejrad.2017.05.044. Epub 2017 Jun 3.

Authors

Emanuele Casciani¹, Giovanni Di Nardo², Simone Chin³, Gabriele Masselli⁴, Elisabetta Polettini⁴, Salvatore Oliva⁵, Denis A Cozzi⁶, Salvatore Cucchiara⁵, Gianfranco Gualdi⁴

Affiliations

¹ Department of Emergency Radiology, "La Sapienza" University of Rome, 00161 Rome, Italy; Salvator Mundi International Hospital, Via delle Mura Gianicolensi 67, 00152 Rome Italy. Electronic address: emanuelecasciani@gmail.com.
² Pediatric Gastroenterology Unit, AORN Santobono-Pausilipon, Naples, Italy; Salvator Mundi International Hospital, Via delle Mura Gianicolensi 67, 00152 Rome Italy.
³ University of New South Wales, Sydney, NSW, 2052, Australia.
⁴ Department of Emergency Radiology, "La Sapienza" University of Rome, 00161 Rome, Italy.
⁵ Department of Pediatrics, Pediatric Gastroenterology Unit, "La Sapienza" University of Rome, 00161 Rome, Italy.
⁶ Pediatric Surgery Unit, "La Sapienza" University of Rome, 00161 Rome, Italy.

PMID: 28668417
DOI: 10.1016/j.ejrad.2017.05.044

Abstract

Objectives: To evaluate the performance of Magnetic Resonance enterography (MRE) in the diagnostic work-up of children presenting with obscure gastrointestinal bleeding (OGIB).

Materials and methods: From January 2014 to January 2016, a single-centre prospective study was performed on all children between 0 and 16 years of age referred to the radiology department for OGIB. Each child underwent MRE examination after negative oesophagogastroduodenoscopy and ileocolonoscopy. MRE results were recorded. All patients proceeded to the related gold standard for diagnostic confirmation.

Results: 25 patients (mean age 10.8±4.5 years, range 4 months to 16 years) were included. MRE was diagnostic in 76% (19 of 25). The most frequent diagnoses were intestinal polyp (28%) and Meckel's diverticulum (16%). Sensitivity and specificity of MRE were 86% and 100% respectively. There were no reported complications during any of the examinations.

Conclusion: MRE is a safe and accurate imaging modality in the evaluation of paediatric OGIB. Its diagnostic capability is comparable to current evidence for capsule endoscopy in this patient group. Further research with larger sample sizes and standardized control groups is warranted to improve our understanding of MRE in this application.

Keywords: MR enterography; Obscure gastrointestinal bleeding; Paediatric.

Publication types

Evaluation Study

MeSH terms

Adolescent
Capsule Endoscopy / methods
Child
Child, Preschool
Female
Gastrointestinal Hemorrhage / etiology*
Humans
Infant
Intestinal Polyps / complications
Intestinal Polyps / diagnosis
Magnetic Resonance Imaging / methods
Male
Meckel Diverticulum / complications
Meckel Diverticulum / diagnosis
Prospective Studies
Sensitivity and Specificity