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P270. Capsule endoscopy (CE) is superior to magnetic resonance enterography (MRE) for the assessment of small bowel lesions in Crohn's disease (CD) patients: a comparative trial

A. Diaz Gonzalez1, S. Rodriguez2, C. Rodriguez De Miguel1, I. Ordas1, A. Jauregui1, E. Ricart1, A. Ramirez1, M. Gallego1, J. Rimola2, M. Pellise1, G. Fernández-Esparrach1, A. Gines1, O. Sendino1, J. Llach1, J. Panes1, B. Gonzalez Suarez1, 1Clinic Hospital, Gastroenterology Department, Barcelona, Spain, 2Clinic Hospital, Radiology Department, Barcelona, Spain

Background

Overall, diagnostic yield of CE for the assessment of small bowel lesions in CD is higher than radiologic imaging techniques. However, with regard to MRE, data are scarce and inconclusive. Colon Capsule Endoscopy (CCE) is a new capsule modality with higher angle view and better image quality compared to conventional small bowel capsule (SBCE). To date, there are no studies comparing CCE to MRE.

Objective: To evaluate and to compare diagnostic yield of MRE and CCE in the assessment of small bowel lesions in CD patients.

Methods

Patients and methods: We included 55 patients (21 men and 34 women) with established (n = 43) or suspected CD (n = 9) and 3 patients with indeterminate colitis. All patients underwent initially the MRE to rule out strictures, and subsequently the CCE was performed. In 37 patients a CCE was performed and the remaining 18 underwent a conventional SBCE.

In seven patients with a suspected stricture in the MRE, an Agile Patency Capsule was performed.

Results

Small bowel lesions were found in 46 patients with CE and in 22 patients with MRE (83.6% vs 45.5%, p < 0.05). Concordance between presence or absence of lesions was 58% (32/55 patients). In seven patients with suspected stricture in MRE (ileum wall thickening), Agile Patency capsule was retrieved with no modifications in 100% of cases. CE detected lesions in proximal and medium small bowel in 16 patients that were not detected by MRE (p = 0.03). Lesions in the terminal ileum were diagnosed by CE in 46 patients and in 24 patients by MRE (83.6% vs 43.6%, p = 0.03).

Conclusion

These results indicate that: 1. CE is superior to MRE for the detection of proximal and medium small bowel lesions in CD. 2. In this study, 100% of patients with a suspected stricture in MRE could be safely evaluated by CE after a correct expulsion of the Agile Patency Capsule.