MRE vs CT enterography in proximal small bowel CD

What is known

• MR enterography identifies small bowel Crohn's with accuracy similar to or better than published series, but discrete proximal small bowel lesions may not always be detected. ¹
• CT enterography cannot demonstrate isolated mucosal abnormalities (e.g. aphthous ulcers), uses ionizing radiation, and is limited by inadequate distension with frequently collapsed jejunal segments. ²
• MR enterography avoids ionizing radiation and is preferred for small bowel evaluation by most institutions, but proximal small bowel distension is often inadequate. ³
• One cited meta-analysis reference reported capsule endoscopy diagnostic accuracy superior to both MR and CT enterography for small bowel Crohn's, without separating MRE from CTE. ⁴

What is unknown / caveats

• No direct MRE-vs-CTE accuracy comparison for the proximal small bowel in the retrieved excerpts
• Proximal/jejunal disease is rare in the cited cohorts, precluding firm accuracy conclusions there ³
• The excerpts characterize each modality but do not quantify a proximal-segment accuracy difference between them.

References

1. Fallis SA, Murphy P, Sinha R, Hawker P, Gladman L, Busby K, Sanders S. Magnetic resonance enterography in Crohn's disease: a comparison with the findings at surgery. Colorectal Dis. 2013. PMID: 23869486.

2. Barlow JM, Goss BC, Hansel SL, Kolbe AB, Rackham JL, Bruining DH, Fletcher JG. CT enterography: technical and interpretive pitfalls. Abdom Imaging. 2015. PMID: 25652953.

3. Bekendam MIJ, Puylaert CAJ, Phoa SKSS, Nio CY, Stoker J. Shortened oral contrast preparation for improved small bowel distension at MR enterography. Abdom Radiol (NY). 2017. PMID: 28393302.

4. Cohen SA, Klevens AI. Use of capsule endoscopy in diagnosis and management of pediatric patients, based on meta-analysis. Clin Gastroenterol Hepatol. 2011;9(6):490-6. PMID: 21440674.

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Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.