Evidence map›Paper›PMID 39692760›Full record

ArticleAbdominal radiology (New York)2025

Discordance between MR enterography and endoscopic detection of Crohn's disease ileal strictures: evidence to inform recommendations.

Mariana Yalon, Payam Mohammadinejad, Akitoshi Inoue, Hiroaki Takahashi, Eric C Ehman, Andrea Esquivel, Ella C Fletcher, Cam J Behnke, Yong S Lee, Jeff L Fidler and 7 more

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Article in Abdominal radiology (New York), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Mariana YalonMayo Clinic, Rochester, USA.
Payam MohammadinejadMayo Clinic, Rochester, USA.
Akitoshi InoueMayo Clinic, Rochester, USA.
Hiroaki TakahashiMayo Clinic, Rochester, USA.
Eric C EhmanMayo Clinic, Rochester, USA.
Andrea EsquivelMayo Clinic, Rochester, USA.
Ella C FletcherMayo Clinic, Rochester, USA.
Cam J BehnkeMayo Clinic, Rochester, USA.
Yong S LeeMayo Clinic, Rochester, USA.
Jeff L FidlerMayo Clinic, Rochester, USA.
Stephanie L HanselMayo Clinic, Rochester, USA.
Vipul JairathWestern University, London, Canada.
Brian G FeaganWestern University, London, Canada.
Florian RiederCleveland Clinic, Cleveland, USA.
Mark E BakerCleveland Clinic, Cleveland, USA.
David H BruiningMayo Clinic, Rochester, USA.
Joel G FletcherMayo Clinic, Rochester, USA. Fletcher.Joel@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate correlation between terminal ileal (TI) stricture diagnosis at MR enterography (MRE) and ileocolonoscopy (IC) in patients with Crohn's disease (CD).

methodsOne hundred and four patients with CD (51% females; 41 ± 15 years) underwent IC and MRE within 3 months in this retrospective case-control study. Positive cases had TI strictures diagnosed by endoscopy (n = 35); or MRE (threshold small bowel dilation ≥ 3cm; n = 34). Negative controls did not have stricture by either modality (n = 35). Three radiologists examined MRE exams, with per-patient stricture diagnosis based on majority agreement. Sensitivity for stricture diagnosis using threshold dilation of 2.5 cm at MRE was also evaluated.

resultsThere were 69 CD TI strictures (57 by endoscopy; 43 by MRE). Sensitivity by endoscopy and MRE criteria were 82.6% (57/69) and 62.3% (43/69), respectively, with additional 20.3% (14/69) of MRE exams classified as "probable stricture" by SAR/AGA/SPR criteria. Lowering MRE small bowel dilation threshold to 2.5 cm increased MRE sensitivity for endoscopically-diagnosed strictures to 71.9% (41/57; up from 56.1% [32/57]), without sacrificing interobserver agreement (κ = 0.684 vs. κ = 0.587). Of 25 new patients diagnosed with a TI stricture using a 2.5 cm threshold by 2 or more readers, 96% (24/25) had hospitalization, small bowel obstruction, endoscopic dilation, and/or surgical resection during clinical follow-up. Nine false negative MRE exams had short strictures with bowel dilation ≥ 2.5 cm.

conclusionEither IC or MRE alone is insufficient to diagnose Crohn's small bowel strictures. Diagnostic criteria should incorporate endoscopic and MRE findings. Lowering threshold dilation to 2.5 cm increases sensitivity in stricture diagnosis and identifies clinically significant strictures.

Indexed as

ColonoscopyCrohn DiseaseEndoscopy, GastrointestinalIntestinal ObstructionMagnetic Resonance ImagingAdultCase-Control StudiesConstriction, PathologicFemaleHumansIleumMaleMiddle AgedRetrospective StudiesSensitivity and SpecificityComputed tomography enterography (CTE)CONSTRICT criteriaMagnetic resonance enterography (MRE)SAR/AGA/SPR criteriaSmall bowel Crohn’s disease (CD)Terminal ileal (TI) stricture diagnosis

Identifiers

PMID39692760

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.