MR enteroclysis in refractory XXXX : proposal and validation of a severity scoring system.

@entity1 @entity5 @entity1593 @entity1050
PURPOSE: To determine magnetic resonance (MR) enteroclysis findings in @entity1 with uncomplicated @entity1593 ( @entity1593 ), @entity1050 ( @entity1050 ) type I, and @entity1050 , to develop and validate a scoring system to identify @entity1 with @entity1050 II and to determine the diagnostic accuracy of MR enteroclysis to detect @entity1593 -related @entity5 . MATERIALS AND METHODS: This study was performed with approval of the institutional review board. One radiologist blinded to clinical details retrospectively evaluated quantitative and qualitative criteria of 28 studies obtained in symptomatic @entity1 with @entity1593 (uncomplicated @entity1593 , n = 10; @entity1050 I, n = 8; @entity1050 II, n = 10). A scoring system was developed by using parameters identified in multivariate analysis to be associated with @entity1050 II, which two radiologists evaluated in a second group of 40 symptomatic @entity1 with @entity1593 . Accuracy to detect @entity5 was assessed in the total study group. Cumulative survival was evaluated in the total study group by using the Kaplan-Meier method. RESULTS: MR enteroclysis could not be used to discriminate between uncomplicated @entity1593 and @entity1050 I. The presence of less than 10 folds per 5 cm jejunum, mesenteric fat infiltration, and bowel wall thickening were associated with @entity1050 II. A positive MR score was defined as the presence of two or more of these features. In the validation group, the MR score was positive in 13 of 15 @entity1 with @entity1050 II (sensitivity, 0.87) and negative in 24 of 25 @entity1 without @entity1050 II (specificity, 0.96). The 5-year survival rate was 95% in @entity1 with a negative MR score and 56% in @entity1 with a positive MR score (P < .0001). MR enteroclysis helped to identify the presence of seven of eight @entity5 and to diagnose absence of @entity5 in 58 of 60 studies. CONCLUSION: MR enteroclysis can be used to investigate the presence of @entity1050 II or @entity5 in symptomatic @entity1 with @entity1593 .
