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  • Title: MR enterography: relationship between intestinal fold pattern and the clinical presentation of adult celiac disease.
    Author: Tomei E, Diacinti D, Stagnitti A, Marini M, Laghi A, Passariello R, Semelka RC.
    Journal: J Magn Reson Imaging; 2012 Jul; 36(1):183-7. PubMed ID: 22359281.
    Abstract:
    PURPOSE: To correlate the clinical presentation of adult celiac disease with various intestinal fold patterns using MR-enterography. MATERIALS AND METHODS: Fifty-four consecutive adult celiac patients (34 female, 20 male, 18 to 62 years) were studied by MR-enterography. Two radiologists blinded to the patients' clinical history evaluated in consensus MR studies, classifying the intestinal fold pattern into four categories: (a) no fold abnormalities, (b) isolated loss of folds in the duodenum, (c) jejunization of ileum, and (d) jejuno-ileal fold pattern reversal. Patients presented with the varying clinical forms of Celiac disease, classified as: (i) typical disease, (ii) atypical disease, and (iii) silent form. RESULTS: Twenty-three patients showed no intestinal fold abnormalities; 11 patients had isolated loss of duodenal folds; 9 patients showed jejunization of ileum and 11 had jejuno-ileal fold pattern reversal. 18/23 (78%) patients with MRI normal fold pattern had the silent clinical form of Celiac disease (Sensitivity 78%; specificity 100%; PPV = 1, NPV = 0.78); 9/11 (82%) patients with the isolated loss of duodenal folds had the atypical clinical form (sensitivity 82%; and specificity 100%; PPV = 1; NPV = 0.82). All 20 patients with the jejunization of ileum and jejuno-ileal fold pattern reversal had typical celiac disease (sensitivity and specificity of 100%; PPV and NPV = 1). CONCLUSION: MR-enterography findings in patients with celiac disease, demonstrates good correlation between MR findings and clinical severity.
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