Gadolinium enhanced magnetic resonance imaging (MRI) with polyethylene glycol offers a sensitive and specific test to detect distal ileitis in children with Crohn’s disease and to differentiate this from other inflammatory gastrointestinal conditions. Researchers from the La Sapienza University of Rome, Italy, performed gadolinium enhanced MRI using polyethylene glycol as an oral contrast agent in 75 children with suspected Crohn’s disease. Median age was 13.6 years and ranged from 8 to 17 years.
The children also underwent ileocolonoscopy with biopsy and were assessed using the Paediatric Crohn’s Disease Activity Index (PCDAI). Twenty-six patients had active Crohn’s disease with distal ileitis. Eighteen showed active ulcerative colitis, while 11 showed spondyloarthropathy and indeterminate ileocolitis. Twenty children acted as controls.
In Crohn’s disease patients, MRI showed marked ileal involvement with increased wall thickness and parietal contrast enhancement. MRI showed good concordance with endoscopy findings and histology results. MRI was negative in all controls and was also negative in 15 ulcerative colitis patients.
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