Layered enhancement at magnetic resonance enterography in inflammatory bowel disease: A meta-analysis

Table 1 Study and patient characteristics of the included studies

Ref.	Year of publication	Country	Study design	Founding sources	Patient spectrum	Inclusion criteria	Disease activity	No. of patients	Age, yr, mean (range)or mean ± SD	Gender, male: female
Del Vescovo et al[19]	2008	Italy	Prospective	NR	Known CD/healthy controls	Proven terminal ileum CD/no history of bowel disease	8 active CD, 8 non-active CD, 7 healthy controls	23	37.5 ± 17.41	15:8
Grieser et al[18]	2012	Germany	Retrospective	NR	Known CD	Referred to MRI for evaluation of disease activity	24 active CD, 24 patients non-active CD	48	37 ± 11	16:32
Koh et al[10]	2001	England	Prospective	NR	Known CD	Clinically symptoma-tic patients referred to MRI by gastroenterologists	23 active CD, 7 patients non-active CD	30	37.6 (18-58)	14:16
Quaia et al[17]	2014	Italy	Retrospective	NR	Known CD	Clinically symptoma-tic patients referred to MRI for evaluation of disease activity	47 active CD, 44 patients non-active CD	91	39.6 ± 17.1	47:44
Zappa et al[11]	2011	France	Retrospective	NR	Known CD	Patients who were to undergo bowel resection for small bowel CD	42 active CD, 11 patients non-active CD	53	35 (15-74)	28:25

¹Data are relative to patients with CD. CD: Crohn’s disease; MRI: Magnetic resonance imaging; NR: Not reported; SD: Standard deviation.

Table 2 Index test and reference standard characteristics of the included studies

Ref.	Vendor (Model)	Magnetstrength, T	Technique	Bowelpreparation	Luminal contrast	Spasmolytic agent	Intravenous contrast	MRI sequences	Postcontrast sequence timing	Index test readers (Years of experience)	Reference standard	Interval1
Del Vescovo et al[19]	Siemens Corp. (Magnetom Symphony)	1.5	EG	NR	1.2-2 L PEG solution orally 45 min prior	Buscopan 20 mg iv	0.1 mmol/kg Gadodiamide (Omniscan)	T2-HASTE, True-FISP, T1-FLASH fs (pre/postcontrast)	15 s, 60 s, 100 s, 160 s, 220 s, 280 s, 340 s, 400 s, 460 s	2 blinded radiologists in consensus (NR)	Endoscopy with biopsy	NR
Grieser et al[18]	GE Healthcare (Twin Speed)	1.5	EC	8 hrs fasting	1-2 L water, 80 mL/min, 20 min prior; 30 mL/min during MRI	Buscopan 10 mg iv	0.2 mL/kg Gd-DTPA (Magnevist)	SSFP, FIESTA, FRFSE, T1-SPGR fs (pre/postcontrast)	60-70 s	2 blinded radiologists in consensus (6,12)	Endoscopy with biopsy and/or surgery	Endoscopy ≤ 3 d; surgery ≤ 10 d
Koh et al[10]	Siemens Corp. (Magnetom Impact)	1	EG	NR	600 mL water orally 30 min prior	Buscopan 1 mg im	0.1 mmol/kg Gadodiamide (Omniscan)	T2-TSE, T1-FLASH, T1-FLASH fs (pre/postcontrast)	20 s	2 blinded radiologists in consensus (NR)	Endoscopy with biopsy and/or surgery	Median 21 d
Quaia et al[17]	Philips (Achieva)	1.5	EG	8 hrs fasting	2 L PEG solution orally 60 min prior and diatrizoate meglumine and diatrizoate sodium solution rectally	Buscopan 40 mg iv	0.2 mL/kg Gadobenate dimeglumine (Multihance)	T2-HASTE, T2-SPAIR, T1-FISP, T1-THRIVE 3D fs (pre/postcontrast)	30 s, 70 s, 3 min, 5 min	2 blinded radiologists in consensus (10,12)	Endoscopy with biopsy or surgery	≤ 30 d
Zappa et al[11]	Philips (Intera)	1.5	EG	NR	1 L mannitol solution orally	Glucagon 1 mg iv	0.2 mL/kg Gadoterate meglumine (Dotarem)	T2-SSH-TSE fs, True-FISP, T1-FLASH 3D (pre/postcontrast)	90 s, 8 min	2 blinded radiologists in consensus (NR)	Surgery	≤ 90 d (mean 24 d, range 1–90 d, median 14 d)

¹Time interval between index test and reference standard. T: Tesla; EG: Enterography; EC: Enteroclysis; NR: Not reported; PEG: Polyethylene glycol; MRI: Magnetic resonance imaging; iv: Intravenous; im: Intramuscular; Gd-DTPA: Gadolinium(-diethylenetriaminepentaacetic acid); HASTE: Half-Fourier single-shot turbo spin-echo; True-FISP: Fast imaging in the steady state procession; FLASH: Fast low angle shot; fs: Fat saturated; SSFP: Steady-state free precession; FIESTA: Fast imaging employing steady state acquisition; FRFSE: Fast relaxation fast spin echo; SPGR: Spoiled gradient echo; TSE: Turbo spin-echo; SPAIR: Half-Fourier single-shot spectral presaturation with inversion recovery; THRIVE: T1-weighted high resolution isotropic volume examination; SSH-TSE: Single-shot turbo spin-echo.

Table 3 Two-by-two data of the included studies

Ref.	TP	TN	FP	FN
Del Vescovo et al[19]	8	14	1	0
Grieser et al[18]	6	21	3	18
Koh et al[10]	7	7	0	16
Quaia et al[17]	16	41	3	31
Zappa et al[11]	34	7	4	8

TP: True positive; TN: True negative; FP: False positive; FN: False negative.