mr enterography vs colonoscopy

The Magnetic Resonance Index of Activity (MARIA) score and the CD MRE Index (CDMI) score have both been developed to use an adequate independent external reference standard and have been successfully validated in independent patient cohorts. MeSH Laboratory abnormalities are nonspecific but can demonstrate anemia, hypoalbuminemia, and elevation of C-reactive protein and erythrocyte sedimentation rate. MRI scans are therefore often used as an alternative to monitor the course of the disease and how it is responding to treatment. Dubron C, Avni F, Boutry N. Prospective evaluation of free-breathing diffusion-weighted imaging for the detection of inflammatory bowel disease with MR enterography in childhood population. That's the only way to tell if you have microscopic inflammation, as far as I know. 2012 Jun;101(6):631-6. doi: 10.1111/j.1651-2227.2012.02607.x. The fistulizing/perforating subtype is characterized by deeply penetrating ulcers that may lead to creation of a sinus tract, fistula formation, or abscess formation. This is normal. Side effects of colonoscopy may include a short period of crampy pain and abdominal swelling; if a biopsy is performed, there may be some blood in stool. Most patients, of course, prefer to examine the intestines through magnetic resonance imaging. During the exam, you will lie on a special MRI table. The sensitivity of MRE for detection of pathologically severe disease was 87% in the terminal ileum (TI) and 88% in the colon. Computed tomographyan increasing source of radiation exposure. Check for errors and try again. Medical imaging in IBD Small-bowel follow through (SBFT) can evaluate the small bowel to detect stricture, fistula, and abscess. This study was performed to compare findings of magnetic resonance enterography (MRE . Church PC, Greer MC, Cytter-Kuint R, Doria AS, Griffiths AM, Turner D, Walters TD, Feldman BM. MR enterography is often recommended when you have Crohn's disease. The test will start about one hour after you complete drinking. Constantly in abdominal pain. MR Enterography has sensitivity to bowel motion alongside T2-weighted sequences which aids the challenge of imaging the bowel. Low RN, Francis IR, Politoske D, Bennett M. Crohns disease evaluation: Comparison of contrastenhanced MR imaging and single-phase helical CT scanning. If the esophagus and stomach are reflected in a very detailed way by means of a tomography, then choosing what is best - an MRI or a colon colonoscopy, it is better to give preference to the latter option. It is noninvasive and does not use ionizing radiation. Side-to-side stapled anastomosis may delay recurrence in Crohn's disease. Griffin N, Grant LA, Anderson S et-al. These will allow the tech to speak to you, even while the MRI is in progress. This article is accredited for one SA-CME credit. The procedure may take around 45 minutes. MR enteroclysis protocol optimization: comparison between 3D FLASH with fat saturation after intravenous gadolinium injection and true FISP sequences. Normal colonic wall thickness is 2-3 mm; 8 mm has been reported in active cases (Figure 5). 3. The symptoms of CD are often more variable depending on the location of GI involvement.2 Clinical manifestations of UC include diarrhea, hematochezia, tenesmus, and fecal urgency. Colon: Aloi et al, 11 2015: Siemens Corp (NA) 1.5: PEG, spasmolytic agent: Conventional MRE: 1 (NA) Yes: Endoscopy with biopsy and consensus: 5 d: . Diffusion weighted imaging is also used to improve sensitivity for detecting diseased bowel-wall segments and peri-enteric soft tissues.26,27 A recent study found improved sensitivity with DWI imaging in comparison with contrast-enhanced sequences for evaluation of inflammatory bowel disease.28. Due to the fact that a special apparatus with a microscopic chamber (colonoscope) is inserted directly through the anus to the end of the dome of the cecum, discomfort may occur, although local anesthesia is preliminarily performed. Patient acceptance of MR colonography with improved fecal tagging versus conventional colonoscopy. 2017 May;47(5):565-575. doi: 10.1007/s00247-017-3790-4. 2011 Feb;9(2):124-9. doi: 10.1016/j.cgh.2010.10.019. A screening program involving direct mucosal visualization by colonoscopy is commonly implemented for patients with pan-colitic UC, due to increased risk for colonic mucosal adenocarcinoma. Ulcerative colitis is typically confined to the mucosa of the rectum and large bowel, while Crohns disease can affect any portion of the GI tract and is often transmural. Objectives: Sessile serrated polyps (SSPs) are suggested to be the precursors of 15-30% of all colorectal cancers (CRCs). Factors that predict incomplete colonoscopy: thinner is not always better. As a rule, modern hardware methods are recommended, since they are the most informative. me personally, I wouldn't do apill cam to save my life. Reference article, Radiopaedia.org (Accessed on 18 Jan 2023) https://doi.org/10.53347/rID-30690. If you were to have one CTE a year it wouldn't be that big of a deal. Drinking anise drops - how to apply the medicine correctly? Cross-sectional imaging with CT and MRI is increasingly being used to evaluate IBD due to their capacity to assess submucosal and deeper tissues of the bowel and to evaluate for extra-intestinal manifestations. Epub 2005 Nov 22. Often, the patient is faced with a choice: an intestinal MRI or a colonoscopy - which is better for diagnosing a particular disease in each individual case, determines the treating gastroenterologist, but preference is usually given to the second method of investigation. MRIs can't take biopsies, they can't remove a polyp and as of late 2008 they still weren't as accurate as a CTE for the small intestine. Magnetic resonance enterography in inflammatory bowel disease. 2008;191 (2): 502-6. Colorectal polyps: detection with dark-lumen MR colonography versus conventional colonoscopy. Burisch J, Munkholm P. Inflammatory bowel disease epidemiology. Magnetic resonance imaging of the gastrointestinal tract. The impact of endoscopists' experience and learning curves and interendoscopist variation on colonoscopy completion rates. Chronic ulcerative colitis without active disease will manifest as wall thickening with mural fat deposition involving the rectum and and/or segments of large bowel. I hate colonoscopies, but I think they are a neccasary evil. While bowel paralytics may reduce image deterioration on MRE, other sources of patient motion, particularly breathing, may be problematic. It involves filling the bowel with fluid that will show up bright on the images and makes the small bowel stand out. You probably can get similar info from either. Improvements in MRI technology now permit three-dimensional volumetric imaging of the entire colon in a single breath hold at high spatial resolution, making VC with MRI possible. Park SH, Huh J, Park SH, Lee SS, Kim AY, Yang SK. Ask your doctor if you should stop taking any of your regular medicinesor supplements. If perforation of the bowel occurs, infection and/or bleeding can also happen. If the APC shows up on the xray, then you are NOT a good candidate for the PCE - forget it!!! Carafate and Bentyl have done nothing. Virtual colonoscopy (VC), also known as computed tomography colonography, is an effective method for detecting polyps. 1. Colorectal polyps and polyposis syndromes. Small bowel MR enterography: problem solving in Crohn's disease. This site needs JavaScript to work properly. Kopylov U, Yung D, Vijayan S. Diagnostic yield of capsule endoscopy versus magnetic resonance enterography and small bowel contrast ultrasound in the evaluation of small bowel Crohns disease: Systemic review and meta-analysis. 2009;29 (6): 1827-46. and transmitted securely. 8600 Rockville Pike Udayasankar UK, Martin D, Lauenstein T, et al. If polyps are found, however, an additional colonoscopy will be needed to remove them. Water is quickly absorbed, so instead you may be given other liquids such as Metamucil, barium, Go . Evaluation of extra intestinal findings/complications FOIA Reply. T2-weighted signal increase is associated with inflammation and edema and is a marker of active Crohns disease.16 However, in CTE, active Crohns disease may look similar to chronic fibrotic changes. Accuracy of CT colonography for detection of large adenomas and cancers. official website and that any information you provide is encrypted Thus, the patient is relieved of the need to re-conduct the procedure to clarify the nature of the build-up or tumor. MR enterographic manifestations of small bowel Crohn disease. Then, they will give you a pair of headphones to wear during the exam. This test may also help track how well certain treatments are working. Magnetic resonance (MR) enterography is an imaging test which produces detailed pictures of your small intestine. Clinical features and natural history of Crohns disease. Acute-on-chronic disease has features of both acute and chronic CD with increased signal on T2W images consistent with active inflammation, also with thickened bowel wall and retained contrast enhancement. Detection of Crohn disease lesions of the small and large bowel in pediatric patients: diagnostic value of MR enterography versus reference examinations. Accessibility CT and 99mTc-WBC vs colonoscopy in the evaluation of inflammation and complications of inflammatory bowel . The frequency of total colonoscopy and terminal ileal intubation in the 1990s. Colonoscopy, in turn, if not painful, then a rather unpleasant diagnostic measure. MR colonography: how does air compare to water for colonic distention?. Incomplete conventional colonoscopy: magnetic resonance colonography in the evaluation of the proximal colon. Schmidt S, Lepori D, Meuwly JY, et al. Fecal tagging: MR colonography without colonic cleansing. My sister had MRE (MRI Enterography) at Mayo Clinic. Sinha R, Verma R, Verma S et-al. Crohn disease of the small bowel: Comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. Dr. Unlike regular X-ray images, CT enterography is able to provide detailed images of tissue and structures, such as bone and blood vessels. Diagnostic accuracy of capsule endoscopy for small bowel Crohn's disease is superior to that of MR enterography or CT enterography. Would you like email updates of new search results? Magnetic resonance (MR) is a non-invasive imaging test that uses a magnetic field (not radiation) to obtain detailed pictures of your small bowel to pinpoint areas of inflammation (swelling and irritation), bleeding, and other small bowel conditions. Unable to load your collection due to an error, Unable to load your delegates due to an error. MR enteroclysis imaging of Crohn disease. Many patients reportedly have active lesions in the small intestine even in patients in clinical remission. Overall accuracy of MRE compared to capsule endoscopy and colonoscopy was 83% and 81% respectively. If necessary, confirm a difficult or difficult diagnosis of MRI is not assigned instead of a colonoscopy. It may help your doctor diagnose inflammation, bleeding, obstructions and other problems. drinks, such as carbonated beverages. The exact etiological pathways leading to IBD have not yet been fully elucidated, but are thought to be multifactorial. During a CT Colonography, a small tube is inserted a few inches into the rectum to gently inflate the colon with gas or air. A nurse will start an IV so that you can be given fluids and injected contrast material in addition to the swallowed contrast. MR imaging in patients with Crohn disease: Value of T2- versus T1-weighted gadolinium-enhanced MR sequences with use of an oral superparamagnetic contrast agent. Epub 2014 Jan 23. The procedure is carried out by the method of circular scanning, during which the person is located on a horizontal platform so that the area of investigation is inside the tomograph. MRE-based disease scores have recently been developed to quantify disease activity in Crohns disease. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn's disease. Ajaj W, Lauenstein TC, Langhorst J, et al. An MRI technologist will Colorectal cancer accounts for 10% of all new cancers and 9% of cancer deaths. She had to stop food the night before but otherwise no clean out. Epub 2017 Mar 10. MR enterography correlates highly with colonoscopy and histology for both distal ileal and colonic Crohn's disease in 310 patients . Is it true that MRIs don't need the clean out prep work beforehand? (2006) Radiology. Shoenut JP, Semelka RC, Magro CM, et al. Bookshelf 5'9", 215 lbs. Dark lumen MR colonography: can high spatial resolution VIBE imaging improve the detection of colorectal masses? If you had one every 6 months, then yeah it might be a bit worse. Magnetic resonance enterography (MRE) is now the preferred imaging modality in inflammatory bowel diseases. Neubauer H, Pabst T, Dick A, et al. MR enterography, also called Magnetic resonance enterography (MRE), is a complementary advanced, accurate and noninvasive diagnostic imaging test to evaluate a broad range of disorders including Crohn's Disease. If necessary, additional images will be created. Appl Radiol. An official website of the United States government. Faecal tagging to avoid colonic cleansing before MRI colonography. Epub 2013 May 3. AGA future trends report: CT colonography. Small bowel hydro-MR imaging for optimized ileocecal distension in Crohns disease: Should an additional rectal enema filling be performed? In general, MRI is much more comfortable than a colonoscopy, since no devices are introduced into the intestine. Giles E, Barclay AR, Chippington S, Wilson DC. Bile-tagged 3d magnetic resonance colonography after exclusive intravenous administration of gadobenate dimeglumine, a contrast agent with partial hepatobiliary excretion. Evaluation of Crohn disease activity with magnetic resonance imaging. Radiation is cumulative and repeated CT studies are not appropriate for non-emergency follow-up. Sinha R, Rawat S. MRI enterography with divided dose oral preparation: Effect on bowel distension and diagnostic quality. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Siddiki HA, Fidler JL, Fletcher JG, et al. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. Ords I, Rimola J, Garca-Bosch O, et al. The MRI machine will scan your body before and after the contrast dye is injected through your IV. Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Diagnosis and Screening for Gastric Conditions, MRI for Patients with Implanted Cardiac Pacemakers and Defibrillators, Endoscopic Retrograde Cholangiopancreatography, Abscesses, which are pus filled pockets, in the intestinal walls. IBD, and particularly CD, is thought to result from an altered gut microbiome and altered immune reactivity, in addition to pro-inflammatory factors mediated by mesenteric adipocytes. This includes hairpins and metal zippers. MR colonography using colonic distention with air as the contrast material: work in progress. During MRI enterography or enteroclysis, multiple images of the abdomen are taken with a magnetic resonance imaging (MRI) machine. Additional findings include reduced distensibility, loss of haustra, and mural hyperenhancement. Background/aims The small bowel is affected in more than half of patients with Crohn's disease (CD) at the time of diagnosis, and small bowel involvement has a negative impact on the long-term outcome. Gastrointestinal prokinetic agents, such as erythromycin or metoclopramide, may be administered to speed gastric emptying.21,22 Recent research suggests that the sensitivity to bowel wall pathology related to CD is adequate even without bowel distention.15 At our institution, oral contrast use is not mandatory, and we rely on the high level of bowel wall contrast, achievable by MRE, to detect active or chronic IBD. Let your doctor know about any allergies or other health conditions, such as diabetes or kidney disease. 4. Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. Whole-body PET/CT scanning: estimation of radiation dose and cancer risk. Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension. HHS Vulnerability Disclosure, Help Frequency and nature of incidental extra-enteric lesions found on magnetic resonance enterography (MR-E) in patients with inflammatory bowel diseases (IBD). The fibrostenotic subtype is characterized by bowel strictures and obstruction, which develop as a result of prolonged, chronic intestinal injury (Figures 2, 4, and Table 3). The specifics will vary depending on MRI hardware and software, radiologist's and referrer's preference, institutional protocols, patient factors (e.g. allergy), and time constraints. Epub 2009 Dec 22. I'm an xray tech, so I deal with all of that every day. Comparison of conventional abdominal CT with MR-enterography in patients with active Crohn's disease and acute abdominal pain. MR enterography, in an analogous way to CT enterography, is most commonly used to evaluate patients with Crohn disease where it is used for assessment of the primary disease and any complications. In the subset of 162 patients who underwent colonoscopy within 30 days of MRE, the overall sensitivity remained 85% but the specificity increased to 85% (kappa=0.69). My MRI showed that I had thickening in the lower intestines so I am going in for a colonoscopy to figure out how bad it is andwhat medicine I will be put on. You will be alone in the room, but you can talk to the people operating the machine. The site is secure. Tillack C, Seiderer J, Brand S, et al. Perianal fistulas in Crohn's disease: MRI diagnosis and surgical planning: MRI in fistulazing perianal Crohn's disease. The availability of MRE expertise and access may represent a relative limitation compared to CTE or SBFT. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. 8600 Rockville Pike government site. provides biphasic improved MRI soft tissue contrast: low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, comprehensive MR examination of the small bowel usually requires axial and coronal, high-resolution ultra-fast sequences such as true fast imaging with, fat-suppressed three-dimensional (3D) T1-weighted breath-hold gradient-echo images of the abdomen and pelvis before and after intravenous gadolinium-based contrast material administration. FOIA Gale H, Sharatz S, Taphey M. Comparison of CT enterography and MR enterography imaging features of active Crohn disease in children and adolescents. Colon segments did not exhibit adequate filling, even in the 2,000 mL group (Table 2). Head-to-head comparison of oral contrast agents for cross-sectional enterography: small bowel distention, timing, and side effects. Dynamic contrast-enhanced MRI of the bowel wall for assessment of disease activity in Crohn's disease. Crohn disease of the small bowel: comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. 2005 Nov 7;167(45):4279-84. Resolution of the elevated T2 signal is a marker of therapeutic change. A significant decrease in the incidence of colorectal cancer and cancer death rates has been attributed to screening measures, earlier detection, and improved therapies. Magnetic resonance enterography has good inter-rater agreement and diagnostic accuracy for detecting inflammation in pediatric Crohn disease. Diagnostic imaging in Crohn's disease: comparison of magnetic resonance imaging and conventional imaging methods. Copyright 2012. MR Enterography. A drug will also be injected to decrease movement of the bowel which can interfere with the images. government site. You swallow the APC early one day, you have an abdominal xray 24-26 hours later. Of these, 310 patients also underwent colonoscopy with biopsy(s) within 90 days. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. 3.1. In addition, for a full inspection of the body, air in the intestinal cavity is required, especially in bends. Comparison of MR enteroclysis with MR enterography and conventional enteroclysis in patients with Crohn's disease. In comparison with colonoscopy, MRE demonstrated a sensitivity of 82% and a specificity of 80% with PPV and NPV of 83% and 80% respectively. You will be asked to briefly hold your breath for short periods of time during the test. Only sounding allows you to accurately assess the state of the described area of the digestive system. You may also be asked not to eat or drink for 6 hours before the test. and transmitted securely. Let your healthcare provider know if you are or could be pregnant. 2009;251:751-61., 25 25. Parallel imaging enhanced MR colonography using a phantom model. The major unmet clinical need is lack of a gold standard diagnostic test; diagnosis is typically made by a combination of clinical features, findings on endoscopy and histopathology, laboratory abnormalities, and imaging. A prospective randomized comparison between two MRI studies of the small bowel in Crohn's disease, the oral contrast method and MR enteroclysis. Small-bowel follow through (SBFT) can evaluate the small bowel to detect stricture, fistula, and abscess. Ha CY, Kumar N, Raptis CA, et al. A recent meta-analysis of CE and MRE demonstrated that CE was superior to MRE for proximal small-bowel Crohns disease.3 Additionally, multiple studies have demonstrated that CE is more sensitive than MRE for detecting small aphthous lesions.4,5,6 It is known that MRE has relatively decreased sensitivity for mild disease restricted to the superficial mucosa. Magnetic resonance enterography , or MR enterography, is a painless imaging test used to diagnose problems specifically in your small intestine. MRE is way more expensive but has no radiation, CTE is less expensive but you have the radiation dose.. Diagnostic Performance of Magnetic Resonance Enterography for Detection of Active Inflammation in Children and Adolescents With Inflammatory Bowel Disease: A Systematic Review and Diagnostic Meta-analysis. Magnetic resonance cholangiopancreatography (MRCP) is a heavily T2-weighted acquisition used to evaluate the biliary system. If you have not had an MRI before prepare to empty your bladder every 5 minutes for the first two hours after you are done due to all the water intake. If you do, you may not be able to have this test. Nylund K, Hausken T, Gilja O. Ultrasound and inflammatory bowel disease. The lack of T2W high signal intensity differentiates chronic disease from acute disease. Epub 2021 Feb 24. 2021 Jul;39(7):633-641. doi: 10.1007/s11604-021-01103-x. Do not carry any metal objects into the exam room. Have any blood tests or other tests ordered by your healthcare provider. Examination may be limited by luminal bowel gas, although this can be reduced by fasting and oral administration of intraluminal contrast.8 Although the ileocecal region and colon are often easily visualized, additional portions of the small bowel can be difficult to see due to overlying bowel loops. MR enterography of Crohn disease: part 1, rationale, technique, and pitfalls. Please enable it to take advantage of the complete set of features! MR imaging of the small bowel in Crohn's disease. Therefore, CRC screening modalities should also be designed to detect high-risk SSPs. HHS Vulnerability Disclosure, Help Conclusion: MRI small-bowel follow-through: prone versus supine patient positioning for best small-bowel distention and lesion detection. My GI might not be down with that, because she likes to take lots of biopsies. I just wish MRI's and Colonoscopies were not 1500 or so and that is with insurance until my deductible is paid bleh! Magnetic resonance colonography for the evaluation of colonic inflammatory bowel disease: correlation with conventional colonoscopy. There are three subtypes of Crohns disease: Active inflammatory, fistulizing/perforating, and fibrostenosing. Ned Tijdschr Geneeskd. Capsule endoscopy versus enteroclysis in the detection of small-bowel involvement in Crohn's disease: a prospective trial. This test is a specialized type of magnetic resonance imaging (MRI), a form of imaging that provides detailed views of your organs through the use of a strong magnetic field. Fat-suppressed techniques are highly useful, and optimal fat suppression is achieved with spectral adiabatic inversion recovery (SPAIR).16,23 T1W images are acquired before and after gadolinium-based contrast is administered in the arterial, venous, and delayed phases. Background and aims: Among the main advantages of this technology is absolute painlessness. Tylenol does nothing. Fornasa F, Benassuti C, Benazzato L. Role of magnetic resonance enterography in differentiating between fibrotic and active inflammatory small bowel stenosis in patients with Crohns disease. Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. Visual disappearing phenomenon can reliably predict the nonadenomatous nature of rectal and rectosigmoid diminutive polyps at endoscopy. Also, the procedure is a better test to view soft-tissue problems. 2012;3 (3): 251-63. Would you like email updates of new search results? Magnetic resonance imaging does not cope with the task because of the anatomical features of the intestine - the presence of multiple bends and loops, which are superimposed on each other. Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohns disease. Magnetic resonance enterography demonstrates a greater ability to depict submucosal pathology compared to other diagnostic modalities. In enterography, large volumes of fluid are ingested. The CT enterography exam involves: Drinking fluid to distend the small bowel CT NCAP (neck, chest, abdomen and pelvis), left ventricular systolic and diastolic function, ultrasound-guided musculoskeletal interventions, gluteus minimus/medius tendon calcific tendinopathy barbotage, lateral cutaneous femoral nerve of the thigh injection, common peroneal (fibular) nerve injection, metatarsophalangeal joint (MTPJ) injection. Magnetic resonance enterography is an imaging test that lets your doctor see detailed pictures of your small intestine. In addition, MR enterography has an evolving though less well documented role to play in the evaluation of other small-bowel . Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2016 Apr 21. The exam produces detailed images to identify and diagnose bleeding, inflammation and problems in the small intestine. www.physorg.com/wire-news/57324784/eu-grant-for-better-monitoring-of-crohns-disease-using-mri.html, Prebiotics And Probiotics: A Simple Guide. A significant decrease in the incidence of colorectal cancer and cancer death rates has been attributed to screening measures, earlier detection, and improved therapies. One liter of 4000 PEG (Polietilenglicol) water solution or 1 liter of 2.5% mannitol solution was administered 30 minutes before MRE and used as the intraluminal contrast agent. Oto A, Kayhan A, Williams JT, et al. MemoryAccessRegister 1 min. The .gov means its official. Epub 2010 Nov 5. Modern imaging using computer tomography and magnetic resonance imaging for inflammatory bowel disease (IBD) AU1. Lee SS, Kim AY, Yang SK, et al. Mapping of T1-values and Gadolinium-concentrations in MRI as indicator of disease activity in luminal Crohn's disease: a feasibility study. Magnetic resonance colonography and virtual magnetic resonance colonoscopy with the 1.0-T system: a feasibility study. Role of 3.0-T MR colonography in the evaluation of inflammatory bowel disease. In 310 patients, the overall sensitivity and specificity of MRE (using endoscopy as a gold standard) were 85% and 80% respectively (kappa=0.65). Pediatr Radiol. Before having this test, you will likely need to: Before you agree to the test or the procedure make sure you know: At Another Johns Hopkins Member Hospital: CT Scan Versus MRI Versus X-Ray: What Type of Imaging Do I Need? 2014; 203 (5):W533-42.