Small-Bowel Tuberculosis: A Comparative Study of MR Enterography and Small-Bowel Follow-Through

Objective: The purpose of this article is to describe the MR enterographic findings of small-bowel tuberculosis (TB) and to compare the imaging findings of small-bowel follow-through (SBFT) with those of MR enterography.

Subjects and methods: Thirty patients (20 male and 10 female) presenting with suspected intestinal TB were enrolled in this prospective study. MR enterography and SBFT were performed within 2 weeks of each other.

Results: Nineteen of the 30 patients were confirmed to have TB. Of these 19 patients, MR enterography depicted ileocecal involvement in nine patients (47%), mural thickening in any other segment of the small bowel in 11 patients (58%), lymphadenopathy in 17 patients (89%), ascites in five patients (26%), and peritoneal enhancement in six patients (32%). In addition, MRI also depicted a splenic granuloma, spondylodiscitis with prevertebral abscess, and small-bowel perforation with collections in one patient each. There was good correlation between MR enterography and SBFT in the depiction of ileocecal involvement and small-bowel mural thickening. However, MR enterography was able to show a higher number of strictures than was SBFT. The sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of TB were 100%, 73%, 86%, and 100%, respectively, for MR enterography and 88%, 70%, 83%, and 78%, respectively, for SBFT. The difference was not statistically significant (p = 0.24).

Conclusion: MR enterography depicts intestinal as well as extraintestinal manifestations of TB. The intestinal manifestations correlate well with SBFT findings. MR enterography has the potential to become the one-stop radiation-free tool in the evaluation of small-bowel TB.