Idiopathic inflammatory bowel disease: endoscopic-radiologic correlation

Abstract

Purpose: To assess the comparative and adjunctive diagnostic value of double-contrast barium enema examination (DCBE) and colonoscopy in cases of idiopathic inflammatory bowel disease.

Materials and methods: Radiographic and endoscopic findings were correlated, with use of a standardized evaluation sheet, in a prospective, blinded study in 99 patients with previously well-established Crohn disease of the colon (CD [ n = 51]) or ulcerative colitis (UC [n = 48]).

Results: Overall, substantial to almost perfect agreement was found in more than 80% of scores with respect to the items of the standardized evaluation sheet in the colon segments depicted with both imaging modalities. Almost perfect agreement (kappa > 60%) was found for two essential diagnostic and differential diagnostic features: aphthoid erosions and fine granularity.

Conclusion: DCBE and colonoscopy are complementary imaging modalities for optimal detection of all mucosal and structural colon lesions, except inflammatory lesions without distortion of the mucosal relief and small numbers of inflamed superficial erosions and ulcers.