Hijaz NM, Attard TM, Colombo JM, Mardis NJ, Friesen CA. Comparison of the use of wireless capsule endoscopy with magnetic resonance enterography in children with inflammatory bowel disease. World J Gastroenterol 2019; 25(28): 3808-3822 [PMID: 31391775 DOI: 10.3748/wjg.v25.i28.3808]
Corresponding Author of This Article
Nadia Mazen Hijaz, MD, Assistant Professor, Doctor, Division of Gastroenterology Hepatology and Nutrition, University of Missouri Kansas City, Children Mercy Hospital Kansas City, 2401 Gillham Road, Kansas City, MO 64108, United States. nmhijaz@cmh.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Diagnostic yield of WCE is similar to that of MRE and SICUS ( +ve MRE 15/25 vs +ve SICUS 16/25 vs +ve WCE 16/25) but the WCE is superior in detecting proximal SB disease
Diagnostic yield of WCE is similar to that of MRE and SICUS ( +ve MRE 19/38 vs +ve WCE 19/38 vs +ve SICUS 21/38) but the CCE is superior in detecting proximal SB disease
Table 2 Highlights baseline characteristics of patient’s demographics and clinical and endoscopic descriptions
All patients CD and IC n = 27
CD n = 20
Age at diagnosis year
13.46 (2.40)
13.48 (2.02)
Male %
74%
75%
Medications ratio (%)
Biological alone or combination therapy
12/27 (44.4%)
11/20 (55%)
Immune modulators with no biologic combination
8/27 (30%)
5/20 (25%)
5 ASA +- steroids
4/27 (15%)
3/20 (15%)
Steroids alone
2/27 (7%)
0/20 (0%)
Antibiotic alone
1/27 (4%)
1/20 (5%)
Phenotype%
Inflammatory
93%
93%
Stricturing
7%
7%
Duration of disease year
1.7 (2.32)
2.1 (2.57)
BMI percentile
57 (32.9)
58.18 (35.83)
PCDAI
10.2 (12.5)
9.8 (11.6)
SB transit time min
233 (115.4)
241(184.99)
Days between MRE and WCE days
4.19 (1.88)
4 (1.90)
Table 3 Magnetic resonance imaging and wireless capsule endoscopy positivity predictive of small bowel involvement in reference pediatric Crohn’s disease activity index > 10 and to histology
Reference standard is PCDAI > 10 indicate active CD
Reference standard is histology in ileum and duodenum
CD only patients (n = 20)
Histology available samples only (n = 14)
MRE
WCE
MRE
WCE
Value
95%CI
Value
95%CI
Value
95%CI
Value
95%CI
SEN
100%
54.07% to 100%
83.3%
35.88% to 99.58%
62.50%
24.49% to 91.48%
50.00%
15.70% to 84.30%
SP
57.14%
28.86% to 82.34%
78.6%
49.20% to 95.34%
50.00 %
11.81% to 88.19%
83.33 %
35.88% to 99.58%
PPV
50%
35.32% to 64.68%
62.5%
36.49% to 82.86%
62.50%
38.87% to 81.37%
80.00%
36.99% to 96.46%
NNP
100%
91.7%
64.29% to 98.53%
50.00 %
23.14% to 76.86%
55.56 %
36.43% to 73.17%
Accuracy
70%
45.72 to 88.11%
80.0%
56.34% to 94.27%
57.14%
28.86-82.34%
64.29%
35.14% to 87.24%
Table 4 Fischer exact performance of each diagnostic test compared to other modality or pediatric Crohn’s disease activity index
Studies compared
All patients (n = 26)
CD only (n = 20)
MRE and WCE
P = 0.428
P = 0.373
MRE and PCDAI
P = 0.395
P = 0.325
WCE and PCDAI
P =0.1892
P = 0.0181
Citation: Hijaz NM, Attard TM, Colombo JM, Mardis NJ, Friesen CA. Comparison of the use of wireless capsule endoscopy with magnetic resonance enterography in children with inflammatory bowel disease. World J Gastroenterol 2019; 25(28): 3808-3822