Digestive Diseases and Sciences

, Volume 56, Issue 10, pp 2906–2913

Magnetic Resonance Enterography: Safe and Effective Imaging for Stricturing Crohn’s Disease

Original Article

DOI: 10.1007/s10620-011-1781-0

Cite this article as:
Ha, C.Y., Kumar, N., Raptis, C.A. et al. Dig Dis Sci (2011) 56: 2906. doi:10.1007/s10620-011-1781-0

Abstract

Background

Symptomatic Crohn’s disease (CD) patients often undergo diagnostic imaging studies for evaluation of disease activity or complications including bowel strictures and obstruction. Magnetic resonance enterography (MRE) provides information regarding disease activity, chronicity, and stricture formation without using ionizing radiation.

Aim

Examine the use of MRE among CD patients presenting with symptoms suggesting obstruction in a tertiary care practice setting.

Methods

We performed a retrospective study of all CD patients undergoing MRE at a tertiary IBD referral center over a 3-year study period including a subgroup analysis of patients presenting obstructive symptoms. Positive and negative findings from MRE were correlated with medical and surgical decision outcomes over the subsequent 90-day period.

Results

In the study, 119 CD patients underwent 133 MRE scans, including 40 scans on individuals presenting with obstructive symptoms. Positive findings of CD including active inflammation, stricturing, and penetrating disease were more frequent in MREs ordered to evaluate obstructive symptoms (87.5%) compared other indications (58.1%, p = 0.001). In patients presenting with obstructive symptoms, MRE findings assisted in directing a change of clinical management towards escalation of medical therapy in 55% and surgery in 32.5%. Review of surgical resection specimens corroborated MRE findings of disease activity and fibrosis in 92% of cases going to surgery.

Conclusions

In practice-based use at a tertiary IBD referral center, MRE provided an effective, radiation-free alternative to computed tomography by providing valuable diagnostic information for evaluating and directing care in Crohn’s disease, particularly for patients presenting with obstructive symptoms.

Keywords

Crohn’s diseaseMagnetic resonance enterographyObstructive symptomsIonizing radiation

Abbreviations

CD

Crohn’s disease

CT

Computed tomography

MRE

Magnetic resonance enterography

MR

Magnetic resonance

SBFT

Small bowel follow-through

SEM

Standard error of the mean

CTE

Computed tomography enterography

ACR

American College of Radiology

UC

Ulcerative colitis

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of GastroenterologyWashington University in St. Louis School of MedicineSt. LouisUSA
  2. 2.Division of Gastroenterology and HepatologyJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Mallinckrodt Institute of RadiologyWashington University in St. Louis School of MedicineSt. LouisUSA