Intestinal Behçet Disease: Evaluation with MR Enterography-A Case-Control Study.

OBJECTIVE. The purposes of this study were to discern imaging findings that distinguish Behcet disease from small-bowel Crohn disease, to find initial performance estimates for these findings, and to evaluate the diagnostic value of MR enterography (MRE) for detecting intestinal Behcet disease. MATERIALS AND METHODS. The MRF, examinations of 30 consecutively registered patients with established intestinal Behcet disease were reviewed by two blinded readers. The frequencies of MRE findings were compared with those obtained for 30 control subjects with small-bowel Crohn disease who were matched for sex and age. The performance estimates were generated with ileocolonoscopic and histopathologic findings as the reference standard. RESULTS. Polypoid pattern and homogeneous mural enhancement were the findings seen more frequently in Behcet disease (p = 0.000) than in Crohn disease (p = 0.003). Stricture formation, long-segment disease, and involvement of more proximal ileal segments favored small-bowel Crohn disease. The ROC AUCs for polypoid pattern and homogeneous mural enhancement in the detection of intestinal Behcet disease were 0.806 and 0.779. The accuracy of MRE was 70.00% (95% CI, 50.60-85.27%); sensitivity, 57.14% (95% CI, 34.02-78.18%), and specificity, 100% (95% Cl, 66.37-100%). CONCLUSION. MRE has potential for use as a radiation-free alternative for clarifying the cause of nonspecific gastrointestinal symptoms in patients with known Behcet disease. However, additional studies are needed to determine the actual value of MRE in patients with Behcet disease and to validate the clinical usefulness of the technique in the detection of unknown intestinal Behcet disease.