Magnetic resonance enterography in Crohn’s disease: How we do it and common imaging findings

Abstract

Crohn’s disease (CD) is a chronic inflammatory disease of the gastrointestinal tract, with unpredictable clinical course by phases of relapses alternating with other of quiescence. The etiology is multifactorial and is still not completely known; globally the westernization of lifestyle is causing an increasing incidence of CD, with peak age of 20-30 years. The diagnostic workup begins with the evaluation of the clinical history, physical examination and laboratory tests. However, the clinical assessment is subjected interobserver variability and, occasionally, the symptoms of acute and chronic inflammation may be indistinguishable. In this regards, the role of magnetic resonance (MR) enterography is crucial to determine the extension, the disease activity and the presence of any complications without ionizing radiations, making this method very suitable for young population affected by CD. The purpose of this review article is to illustrate the MR enterography technique and the most relevant imaging findings of CD, allowing the detection of small bowel involvement and the assessment of disease activity.

Magnetic resonance imaging in the management of Crohn’s disease: a systematic review and meta-analysis

“…Magnetic resonance enterography (MRE) can detect fibrostenotic disease of stricturing type, observed as a fixed narrowing of the affected segment [ 36 , 37 ]. Both T1- and T2-weighed images can demonstrate chronic fibrotic strictures, showing inhomogeneous contrast enhancement in post-IV contrast sequences but without the surrounding inflammation of mesentery or obvious edema [ 36 , 38 ]. The absence of gut motility in active or chronic CD is observed using fast cine sequence (T2-weighted SSFP or echo planar imaging techniques).…”

Radiologische Charakterisierung chronisch-entzündlicher Darmerkrankungen

“…In der Submukosa kommt es zu Fettgewebseinlagerungen, was zu einer Schichtung in den T2-gewichteten Sequenzen führt. Fettunterdrückte Sequenzen füh-ren zu einer Signalminderung und damit zu einer Differenzierung zu einem akuten Ödem [14,16]. Befunde bei Colitis ulcerosa…”

Magnetic resonance imaging, ultrasound and magnetogastrography evaluation on the gastrointestinal system

“…Magnetic resonance enterography has been proven to play a crucial role to determine the extension [24], disease activity, and the presence of any complication without utilizing ionizing radiation. This technique is particularly adequate to assess Crohn´s disease which is mostly manifested in the young population.…”