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Master Thesis

Apport de l’injection de gadolinium en entéro-IRM pour le diagnostic de récidive anastomotique de maladie de Crohn après résection iléo-cæcale

Abstract : Purpose: To assess the impact of gadolinium injection in Magnetic Resonance Imaging (MRI) to detect anastomotic recurrence after ileocaecal resection in Crohn’s disease (CD). Methods : The MRIs from 58 patients followed-up between 2007 and 2013 in Saint-Antoine Hospital for CD with ileocaecal resection were retrospectively reviewed by 3 radiologists in a two-step approach: without gadolinium injection and then after gadolinium injection. The patients were ranked M1 (no disease), M2 (probably no disease), M3 (I don’t know), M4 (probably ill), and M5 (certainly ill). The reference standard was established by a senior gastroenterologist with biological and endoscopic items. Results: By grouping M1+M2 and M4+M5, before injection sensitivity was 64%, specificity 85%, positive predictive value 81% and negative predictive value 70%. After injection, sensitivity was 64.3%, specificity 81.4%, positive predictive value 78%, and negative predictive value 69%. There was no significant change in the Receiver Operating Characteristic curves before and after injection (p=0.19, DeLong method). Before gadolinium injection, the Area Under Curve was 0,738 with a confidence interval (CI) of 95% between 0,606 and 0,845, and after injection of 0,775 with a CI of 95% between 0,646 and 0,874. Our results agreed with the reference standard in 70.6% of the cases before injection and 68.9% after. Gadolinium improved concordance in 3 cases and downgraded results in 4 cases. Conclusion: Gadolinium did not significantly improve the diagnosis of anastomotic recurrence after ileocaecal resection in CD.
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Master Thesis
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Submitted on : Wednesday, January 6, 2016 - 5:12:40 PM
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  • HAL Id : dumas-01251797, version 1

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Alix Fechner. Apport de l’injection de gadolinium en entéro-IRM pour le diagnostic de récidive anastomotique de maladie de Crohn après résection iléo-cæcale. Médecine humaine et pathologie. 2015. ⟨dumas-01251797⟩

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