Capsule Endoscopy Improves Crohn's Disease Diagnosis
Improved sensitivity and diagnosis compared with enterography for patients without stenosis
WEDNESDAY, Feb. 9 (HealthDay News) -- For patients without endoscopic or clinical suspicion of stenosis, capsule endoscopy (CE) demonstrates improved sensitivity for detection of Crohn's disease (CD) in the terminal ileum and superior diagnosis in the proximal small bowel, according to a study published in the February issue of Clinical Gastroenterology and Hepatology.
Michael Dam Jensen, M.D., from Lillebaelt Hospital Vejle in Denmark, and colleagues examined data from 93 patients with inflammatory bowel disease who were scheduled to undergo ileocolonoscopy, magnetic resonance enterography (MRE), and computed tomography enterography (CTE). If stenosis was excluded, patients also underwent CE. Physicians performing the procedures were unaware of patient histories or findings from other examinations.
The investigators identified 21 patients with CD in the terminal ileum. For diagnosis of CD in the terminal ileum, CE had sensitivity and specificity of 100 and 91 percent, MRE had 81 and 86 percent, and CTE had 76 and 85 percent, respectively. Proximal CD was detected in 18 patients using CE, compared with two patients using MRE and six patients using CTE. Small bowel stenosis was seen in five patients using CTE and one patient using MRE. Cross-sectional imaging indicated additional stenosis in two of the patients who underwent complete ileocolonoscopies.
"In patients with suspected or newly diagnosed CD without endoscopic or clinical suspicion of stenosis, CE could be the new gold standard and first-line modality for detection of small bowel CD beyond the reach of the colonoscope," the authors write.