MRI Differentiating Gut TB and Crohn's
Condition: Crohn Disease; Intestinal Tuberculosis
MeSH terms: Tuberculosis; Crohn Disease
Study type: Observational

Summary: 
      It is clinically challenging to differentiate Crohn's disease from gut tuberculosis
      especially in regions endemic of tuberculosis infection. The investigators plan to perform
      magnetic resonance enterography (MRE) who presented to our hospital in Shenzhen, China for
      new onset of lower gastrointestinal symptoms and ileocecal mucosal lesions of uncertain
      diagnosis as evidenced by the presence of inflammation, ulceration, strictures or nodules on
      colonoscopy. MRE findings will be independently interpreted by two radiologistsThe role of
      MRE in distinguishing gut tuberculosis from Crohn's disease will be determined.
    

Detailed description: 
      The clinical presentation of gut tuberculosis and Crohn's disease is very similar. In areas
      endemic of tuberculosis infection, differentiating the two diseases remains difficult. Both
      disease entities can have similar clinical, endoscopic and histological findings. Yet,
      wrongly diagnosing gut tuberculosis as Crohn's disease can potentially result in disastrous
      outcomes, especially when anti-tumor necrosis factor therapy, an important therapeutic option
      for Crohn's disease, can result in fulminant reactivation of tuberculosis.

      Magnetic resonance enterography (MRE) is emerging as a effective imaging modality in
      evaluating the disease status of Crohn's disease. MRE, unlike computed tomography, emits no
      radiation, and is suitable for repeated serial imaging in younger-age populations.
      Ulcerations, strictures, transmural enhancement and mesenteric combing of the small bowel can
      be clearly demonstrated via MRE in Crohn's disease. Yet, the utilization of MRE in diagnosing
      gut tuberculosis remains largely unexplored. Whether MRE can be used to differentiate gut
      tuberculosis from Crohn's disease remains unknown.

      The investigators plan to consecutively recruit 150 patients presenting to our hospital in
      Shenzhen, China, for new onset of lower gastrointestinal symptoms and ileocecal mucosal
      lesions of uncertain diagnosis as evidenced by the presence of inflammation, ulceration,
      strictures or nodules on colonoscopy.All recruited participants will undergo MRE, to be
      performed on a 1.5 Tesla scanner (Magnetom Avanto, Siemens Healthcare, Erlangen, Germany).
      MRE findings will be independently interpreted by two radiologists with special expertise in
      abdominal MR imaging and blinded to the patients' clinical data. The relationship between
      radiological patterns and clinical, endoscopic and histological findings will be analyzed.
      The role of MRE in distinguishing gut tuberculosis from Crohn's disease will be determined.
    

Intervention name(s): Magnetic resonance imaging
Intervention type(s): Diagnostic Test
Intervention description(s): Enterography performed via magnetic resonance imaging
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Consecutive patients with new-onset of lower gastrointestinal symptoms and ileocecal
        mucosal lesions of uncertain diagnosis as evidenced by the presence of inflammation,
        ulceration, strictures or nodules on colonoscopy.
      
Keywords: TB; CD; MRE; ileocecal