TY - JOUR
T1 - Evaluating the diagnostic accuracy of magnetic resonance imaging in distinguishing strictures in Crohn’s disease
T2 - a systematic review and meta-analysis
AU - Kobeissy, Abdallah
AU - Merza, Nooraldin
AU - Nawras, Yusuf
AU - Bahbah, Eshak I.
AU - Al-Hillan, Alsadiq
AU - Ahmed, Zohaib
AU - Hassan, Mona
AU - Alastal, Yaseen
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/12
Y1 - 2023/12
N2 - Purpose: This systematic review and meta-analysis sought to assess the diagnostic accuracy of magnetic resonance imaging (MRI) in distinguishing fibrotic from inflammatory strictures in Crohn’s disease (CD) patients. Methods: A rigorous and systematic exploration of five key databases yielded studies that met predefined criteria. Data were extracted for a comprehensive meta-analysis using MetaDiSC and MetaDTA software, providing diagnostic accuracy measures. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was utilized for evaluating the methodological quality and potential bias within the studies. Results: The systematic review involved the evaluation of 7437 records, culminating in the inclusion of 22 studies. In detecting fibrotic strictures in CD patients, MRI exhibited a pooled sensitivity of 85.20% (95% CI: 76.10–91.20%) and specificity of 96.00% (95% CI: 87.80–98.70%). For differentiating fibrotic strictures from inflammatory stenosis, the sensitivity was 81.5% (95% CI: 70.2–89.20%), and the specificity was 97.2% (95% CI: 90.0–99.3%). In terms of assessing the severity of strictures, sensitivity stood at 90.4% (95% CI: 78.1–96.1%) and specificity at 89.4% (95% CI: 57.4–98.2%). The consistency of the diagnostic accuracy was observed across different geographical locations and the various reference tests applied in the studies. Conclusions: The results of this meta-analysis underscore the robust diagnostic accuracy of MRI in detecting fibrotic strictures, distinguishing between fibrotic and inflammatory strictures, and evaluating stricture severity in CD patients. These findings support the integration of MRI into standard diagnostic protocols for patients with CD. Further large-scale, multicenter trials are warranted to confirm these results and to identify any potential limitations associated with the application of MRI in this clinical setting.
AB - Purpose: This systematic review and meta-analysis sought to assess the diagnostic accuracy of magnetic resonance imaging (MRI) in distinguishing fibrotic from inflammatory strictures in Crohn’s disease (CD) patients. Methods: A rigorous and systematic exploration of five key databases yielded studies that met predefined criteria. Data were extracted for a comprehensive meta-analysis using MetaDiSC and MetaDTA software, providing diagnostic accuracy measures. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was utilized for evaluating the methodological quality and potential bias within the studies. Results: The systematic review involved the evaluation of 7437 records, culminating in the inclusion of 22 studies. In detecting fibrotic strictures in CD patients, MRI exhibited a pooled sensitivity of 85.20% (95% CI: 76.10–91.20%) and specificity of 96.00% (95% CI: 87.80–98.70%). For differentiating fibrotic strictures from inflammatory stenosis, the sensitivity was 81.5% (95% CI: 70.2–89.20%), and the specificity was 97.2% (95% CI: 90.0–99.3%). In terms of assessing the severity of strictures, sensitivity stood at 90.4% (95% CI: 78.1–96.1%) and specificity at 89.4% (95% CI: 57.4–98.2%). The consistency of the diagnostic accuracy was observed across different geographical locations and the various reference tests applied in the studies. Conclusions: The results of this meta-analysis underscore the robust diagnostic accuracy of MRI in detecting fibrotic strictures, distinguishing between fibrotic and inflammatory strictures, and evaluating stricture severity in CD patients. These findings support the integration of MRI into standard diagnostic protocols for patients with CD. Further large-scale, multicenter trials are warranted to confirm these results and to identify any potential limitations associated with the application of MRI in this clinical setting.
KW - Crohn’s disease
KW - Diagnostic test accuracy
KW - Fibrotic strictures
KW - Magnetic resonance imaging
KW - Meta-analysis
UR - https://www.scopus.com/pages/publications/85175058359
UR - https://www.scopus.com/pages/publications/85175058359#tab=citedBy
U2 - 10.1007/s00384-023-04544-0
DO - 10.1007/s00384-023-04544-0
M3 - Review article
C2 - 37882852
AN - SCOPUS:85175058359
SN - 0179-1958
VL - 38
JO - International Journal of Colorectal Disease
JF - International Journal of Colorectal Disease
IS - 1
M1 - 258
ER -