Pictorial Essay

Pediatric Radiology

, Volume 37, Issue 2, pp 201-208

First online:

Pelvic MRI in children with Crohn disease and suspected perianal involvement

  • Brendan EssaryAffiliated withDepartment of Radiology, Massachusetts General HospitalDepartment of Radiology, FND 216 Email author 
  • , John KimAffiliated withDepartment of Radiology, Massachusetts General Hospital
  • , Sudha AnupindiAffiliated withDepartment of Radiology, Children’s Hospital of Philadelphia
  • , J. Aubrey KatzAffiliated withDepartment of Pediatric Gastroenterology, Massachusetts General Hospital
  • , Katie NimkinAffiliated withDepartment of Radiology, Massachusetts General Hospital

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Abstract

MRI is an important imaging tool in evaluation of adult and pediatric patients with Crohn disease. Pelvic MRI, in particular, has become the method of choice to evaluate for perianal fistulas and associated complications of Crohn disease. MRI can define the extent and location of perianal fistulas and abscesses, as well as provide critical information for operative management. In this pictorial essay, we describe useful MRI techniques for evaluation of perianal complications in pediatric patients with Crohn disease. We review pertinent anatomy and illustrate typical examples of perianal fistulas with and without abscess. We show one case of clinically suspected perianal fistula that was actually a pilonidal sinus.

Keywords

Children MRI Crohn disease Perianal fistula