Diagnostic Value Of MRI For Small Bowel Crohn's Disease: A Meta-Analysis

Objective To assess the diagnostic value of MRI for small bowel Crohn's disease, and to evaluate the diagnostic yield of MREg compared with WCE and CTEg in patients with suspected CD using a Meta-analysis.Materials and Methods The trials were searched from MEDLINE, EMBASE, Cochrane Library and SinoMed databases; the Criteria for inclusion and exclusion were based on the standard for diagnosis tests. The data of the included studies were extracted, and methodological quality of the studies was assessed according to the QUADAS independently by two reviewers. And any disagreements were resolved through discussion. STATA11.0 software was used to analyze sensitivity, specificity, the AUC of SROC and so on. Among these trials, ones comparing the diagnostic yield of MREg with WCE, CT in patients with suspected CD were undertaken. Data on diagnostic yield among various modalities were extracted, pooled, and analyzed. Weighted incremental yield(IYw) (diagnostic yield of MREg– diagnostic yield of comparative modality) and 95% confidence intervals(CIs) of MREg over comparative modalities were calculated.Results A total of 8 trials involving 233 patients were included. The sensitivity and specificity of MRI were 0.89(0.80,0.94) and 0.97(0.78,1.00), respectively; and the AUC of SROC curve for MRI were 0.94. Two trials (n=53) compared MREg with CTEg, two trials (n=43) compared MREg with WCE. Yields in the subgroup were MREg vs. CTEg: 64% vs. 68% (IYw =-0.04[95%CI(-0.22, 0.14),P=0.68]), MREg vs. WCE: 35% vs. 40%( IYw =-0.05[95%CI(-0.25, 0.15), P=0.65]), they are no statistical significant.Conclusion Our meta-analysis demonstrates that MRI can be regarded as an effective and feasible method for small bowel Crohn's disease, and MREg compared with WCE, CTEg, they are no statistical significant, but more high quality trials are required.