Title of article :
Safety and effectiveness of MRE in comparison with CTE in diagnosis of adult Crohn’s disease
Author/Authors :
Iman Rashin Department of Pharmacoeconomics and Pharmaceutical Administration - Faculty of Pharmacy - Tehran University of Medical Sciences - Tehran, Iran , Davari Majid Department of Pharmacoeconomics and Pharmaceutical Administration - Faculty of Pharmacy - Tehran University of Medical Sciences - Tehran, Iran , Keshtkar Abbas Health Equity Research Center - Tehran University of Medical Sciences - Tehran, Iran , Sadat Sajadian Elaheh Student Research Committee - Principal Moderator - School of Public Health - Tehran University of Medical Sciences - Tehran, Iran , Delavari Alireza Faculty of Medicine - Tehran University of Medical Sciences - Tehran, Iran
Abstract :
Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal tract that is characterized by recurrent
attacks and frequent recovery. The lifelong course of this disease requires frequent assessment of the disease activity. The aim of this
study was to compare the effectiveness and safety of computed tomography enterography (CTE) to magnetic resonance enterography
(MRE) in adults with CD.
Methods: A systematic review of the literatures was performed to evaluate the effectiveness and safety of CTE in comparison with
MRE. PubMed, Cochrane Library, Scopus, Web of Science, and Embase were searched. Effectiveness outcomes included were
sensitivity, specificity, diagnosis difference, diagnostic odds ratio, and positive and negative likelihood. Quality assessment of the
studies was conducted using the QADAS score. Meta-analysis was done by RevMan 5.3 for selected outcomes.
Results: Five studies had eligibility for analyzing effectiveness. The meta-analysis results showed that diagnosis difference of MRE
and CTE, for diagnosing active CD (0.03 CI 95% -0.07–0.13), fistula (-0.01 CI 95% -0.09–0.07), and cramping (-0.02 CI 95% -0.1–
0.06) were not statistically significant. Six studies were finally selected for safety assessment. The results showed that people who are
examined with CTE frequently are at increased risk of developing cancer significantly, as they receive more than 50 msv of radiation
per year.
Conclusion: There was no significant difference between MRE and CTE in diagnosis of Crohn’s activity, detection of bowel
obstruction, and detection of fistula and stenosis of the alimentary canal. However, the assessment of the safety profile of MRE and
CTE showed that MRE is meaningfully safer than CTE for evaluating the recurrence of CD.
Keywords :
Crohn disease , Radiation 50 mSv , Computed tomography enterography , Magnetic resonance enterograph
Journal title :
Medical Journal of the Islamic Republic of Iran