Usefulness of magnetic resonance enterography in the clinical decision-making process for patients with inflammatory bowel disease

Abstract

Objective: To evaluate the impact of magnetic resonance enterography (MRE) diagnosis on clinical decision-making regarding treatment choice and maintenance of treatment over time in patients with inflammatory bowel disease (IBD).

Methods: A cohort of patients who underwent MRE for IBD assessment between 2011 and 2014 was analyzed. From clinical records, we retrospectively retrieved their demographic data and clinical data on their IBD at the time of MRE, the results of MRE and the patient's clinical course. Medical management decisions made during the three months following MRE and at the 15-month follow-up were assessed.

Results: In total, 474 MREs were reviewed. In the first three-month period, MRE results led to changes in the medical management of 266 patients (56.1%). Of those, maintenance therapy was altered in 140 patients (68.3%) (90.7% step-up and 9.3% top-down strategy), 65 (24.4%) were prescribed a course of steroids and 61 (22.9%) underwent surgery. MRE confirmed a CD diagnosis in 14/41 patients (34.1%) previously diagnosed with indeterminate colitis or ulcerative colitis and in 4/18 patients (22.2%) with suspected IBD. At the 15-month follow-up, treatment remained unchanged in 289 patients (65.8%).

Conclusions: These results suggest that MRE is a diagnostic tool that provides valid information for the clinical-decision making process for patients with CD.

Keywords: Clinical decision-making; Enfermedad inflamatoria intestinal; Enterografía por resonancia magnética; Inflammatory bowel disease; Magnetic resonance enterography; Toma de decisiones clínicas.