Pediatrik İnflamatuar Bağırsak Hastalıklarının Tanısında ve Ayrımında Manyetik Rezonans Enterografinin Rolü

Year 2023, Volume: 33 Issue: 6, 726 - 731, 31.12.2023

Eda Almus , Özge Yapıcı

https://doi.org/10.54005/geneltip.1300173

Abstract

Amaç: İnflamatuar barsak hastalıkları Crohn hastalığı ve ülseratif kolit olarak ikiye ayrılır. Tedavi stratejileri farklı olduğundan ayrımları önemlidir. Bu çalışmada klinik olarak Crohn hastalığı veya ülseratif kolit tanısı alan pediatrik hastaların Manyetik Rezonans Enterografi (MRE) bulgularının değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Onsekiz yaş altı MRE incelemesi bulunan hastalar retrosepektif olarak tarandı. Bu hastalardan Crohn hastalığı veya ülseratif kolit tanısı bulunan 55 hasta çalışmaya dahil edildi. Barsak duvar kalınlaşması, mezenterik yağ doku değişiklikleri ve hastalık komplikasyonları değerlendirildi, bulgular kaydedildi. İnflamatuar barsak hastalığı tanısı bulunan hastalarda, MRE’nin Chron veya ülseratif kolit tanısındaki sensitivite ve spesifiteleri hesaplandı.
Bulgular: Chron hastalığı tanısı bulunan 3 hastada (%7.3) and ülseratif kolit tanısı bulunan 6 hastada (%42.9) rektumdan proksimal kolonik segmentlere uzanan tutulum mevcuttu. Crohn tanısı bulunan 11 hastada (%26.8) atlayıcı lezyonlar vardı. İnflamatuar hastalığı tanısı bulunan hastlarda MRE’nin Crohn hastalarında sensititivtesi %56.1 ve spesifistesi %100, ülseratif kolit hastalarında sensitivitesi %42.9 ve spesifitesi %90.2 olarak hesaplandı.
Sonuç: MRE inflamatuar barsak hastalıklarının bulgularının ve komplikasyonlarının tanımlanmasında yardımcıdır. Crohn hastalığı ile ülseratif kolit ayrımında MRE’nin sensititivtesi düşük olmakla birlikte yüksek spesifiste oranları ile tanıda yardımcı olabilir.

Keywords

Crohn hastalığı, İnflamatuar barsak hastalığı, Manyetik Rezonans Enterografi, Ülseratif Kolit

The Role of Magnetic Resonance Enterography for Detection and Differentiation of Pediatric Inflammatory Bowel Diseases

Abstract

Background/Aims: Inflammatory bowel diseases (IBD) are of two types: Crohn’s disease (CD) and ulcerative colitis (UC). The differential diagnosis of these two diseases is important because their treatment strategies are different. The present study aimed to evaluate the Magnetic Resonance Enterography (MRE) findings of pediatric patients who were clinically diagnosed with CD or UC.
Material and Method: The patients under the age of 18, who underwent MRE examination, were retrospectively screened. Fifty five of those patients, who were clinically diagnosed with CD or UC, were included in the study. Bowel wall thickening, mesenteric fat tissue changes and complications were evaluated, and the findings were recorded. The sensitivity and specificity of MRE in the diagnosis of CD and UC in IBD patients were calculated.
Results: Three of the patients clinically diagnosed with CD (7.3%) and six patients who had UC (42.9%) had involvement from the rectum to the proximal colonic segments (continuous lesions). Of those diagnosed with CD, 11 (26.8%) had skip lesions. In patients with IBD, the sensitivity of MRE for the diagnosis of CD was 56.1% and the specifity was 100%. The sensitivity of MRE for the diagnosis of UC was 42.9% and the specificity was 90.2%.
Conclusion: MRE is helpful to identify the signs and complications of inflammatory bowel diseases. Although MRE has low sensitivity to differentiate between CD or UC in pediatric patients, it may help with its high specificity rates.

Keywords

Crohn, Inflammatory Bowel Diseases, Magnetic Resonance Enterography, Ulcerative Colitis

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