Abstract
Evaluation of intestinal involvement in Crohn’s disease requires a deep knowledge of the anatomical, structural, and functional characteristics of the different parts composing the small and the large bowel.
Within the latter, particular care must be taken in the assessment of the anal canal, considering the high incidence of complications such as fistulas and abscesses.
When assessing magnetic resonance enterography images, the primary aim is detecting active inflammation, due to primary onset or recurrence, or remission as a consequence of a successful treatment.
Nevertheless, when medical therapy proves to be insufficient, surgery must be considered.
This topic is particularly meaningful in Crohn’s disease patients that are often young and may incur multiple interventions during lifetime.
Therefore, awareness of the different operating techniques is crucial not only for the assessment of surgical outcomes and possible complications, but especially for a proper detection of intestinal relapses.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Mazziotti S, Ascenti G, Scribano E, Gaeta M, Pandolfo A, Bombaci F, Donato R, Fries W, Blandino A. Guide to magnetic resonance in Crohn's disease: from common findings to the more rare complicances. Inflamm Bowel Dis. 2011;17(5):1209–22. https://doi.org/10.1002/ibd.21548. Epub 2010 Nov 5
Cicero G, Mazziotti S. Crohn's disease at radiological imaging: focus on techniques and intestinal tract. Intest Res. 2021;19(4):365–78. https://doi.org/10.5217/ir.2020.00097. Epub 2020 Nov 25. PMID: 33232590; PMCID: PMC8566824
Laghi A, Hara AK. Small bowel disease. In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the abdomen and pelvis 2018–2021: diagnostic imaging—IDKD book; 2018. Mar 21.
Cronin C, Delappe E, Lohan DG, et al. Normal small bowel wall characteristics on MR enterography. Eur J Radiol. 2010;75:207–11.
Griffin N, Grant LA, Anderson S, Irving P, Sanderson J. Small bowel MR enterography: problem solving in Crohn's disease. Insights Imaging. 2012;3(3):251–63. https://doi.org/10.1007/s13244-012-0154-3. Epub 2012 Mar 17. PMID: 22696087; PMCID: PMC3369125
Kayhan A, Oommen J, Dahi F, et al. Magnetic resonance enterography in Crohn’s disease: standard and advanced techniques. World J Radiol. 2010;2:113–21.
Furukawa A, Saotome T, Yamasaki M, et al. Cross sectional imaging in Crohn disease. Radiographics. 2004;24:689–702.
Horsthius K, Stoker J. MRI of perianal Crohn’s disease. Am J Roentgenol. 2004;183:1309–15.
Halligan S, Stoker J. Imaging of fistula in ano. Radiology. 2006;239:18–33.
Morris J, Spencer JA, Ambrose S, et al. MR imaging classification of perianal fistulas and its implications for patient management. Radiographics. 2000;20:623–35.
Cicero G, Ascenti G, Blandino A, Pallio S, Abate C, D'Angelo T, Mazziotti S. Magnetic resonance imaging of the anal region: clinical applications. J Clin Imaging Sci. 2020;10:76. https://doi.org/10.25259/JCIS_180_2020. PMID: 33274120; PMCID: PMC7708963
Seifarth C, Kreis ME, Gröne J. Indications and specific surgical techniques in Crohn's disease. Viszeralmedizin. 2015;31(4):273–9. https://doi.org/10.1159/000438955. Epub 2015 Aug 14. PMID: 26557836; PMCID: PMC4608647
Ingallinella S, Campanelli M, Antonelli A, Arcudi C, Bellato V, Divizia A, Franceschilli M, Petagna L, Sensi B, Sibio S, Siragusa L, Sica GS. The role of active inflammation and surgical therapy in Crohn's disease recurrence. Gastroenterol Res Pract. 2020;2020:2845407. https://doi.org/10.1155/2020/2845407. PMID: 33456458; PMCID: PMC7785378
El Megeed KHA, Saleh SAB, Mohamed AE, Anwar CA. Predictors of surgical intervention in patients with inflammatory bowel disease. Egypt J Intern Med. 2021;33:19.
Michelassi F, Sultan S. Surgical treatment of complex small bowel Crohn disease. Ann Surg. 2014;260(2):230–5. https://doi.org/10.1097/SLA.0000000000000697.
Meima-van Praag EM, Buskens CJ, Hompes R, Bemelman WA. Surgical management of Crohn's disease: a state of the art review. Int J Color Dis. 2021;36(6):1133–45. https://doi.org/10.1007/s00384-021-03857-2. Epub 2021 Feb 2. PMID: 33528750; PMCID: PMC8119249
Bemelman WA, Warusavitarne J, Sampietro GM, Serclova Z, Zmora O, Luglio G, de Buck van Overstraeten A, Burke JP, Buskens CJ, Colombo F, Dias JA, Eliakim R, Elosua T, Gecim IE, Kolacek S, Kierkus J, Kolho KL, Lefevre JH, Millan M, Panis Y, Pinkney T, Russell RK, Shwaartz C, Vaizey C, Yassin N, D'Hoore A. ECCO-ESCP consensus on surgery for Crohn's disease. J Crohns Colitis. 2018;12(1):1–16. https://doi.org/10.1093/ecco-jcc/jjx061.
Cicero G, Ascenti G, Blandino A, Trimarchi R, Booz C, Vogl TJ, D'Angelo T, Mazziotti S. Elective surgery outcomes in inflammatory bowel disease: interpretation at magnetic resonance enterography. Jpn J Radiol. 2021;39(7):633–41. https://doi.org/10.1007/s11604-021-01103-x. Epub 2021 Feb 24
Toh JW, Stewart P, Rickard MJ, Leong R, Wang N, Young CJ. Indications and surgical options for small bowel, large bowel and perianal Crohn's disease. World J Gastroenterol. 2016;22(40):8892–904. https://doi.org/10.3748/wjg.v22.i40.8892. PMID: 27833380; PMCID: PMC5083794
Reynolds IS, Doogan KL, Ryan ÉJ, Hechtl D, Lecot FP, Arya S, Martin ST. Surgical strategies to reduce postoperative recurrence of Crohn's disease after ileocolic resection. Front Surg. 2021;17(8):804137. https://doi.org/10.3389/fsurg.2021.804137. PMID: 34977147; PMCID: PMC8718441
Kono T, Ashida T, Ebisawa Y, et al. A new antimesenteric functional end-to-end handsewn anastomosis: surgical prevention of anastomotic recurrence in Crohn’s disease. Dis Colon Rectum. 2011;54(5):586–92.
Luglio G, Rispo A, Imperatore N, et al. Surgical prevention of anastomotic recurrence by excluding mesentery in Crohn’s disease: the SuPREMe-CD study—a randomized clinical trial. Ann Surg. 2020;272(2):210–7.
Williams JL, Shaffer VO. Modern management of perianal Crohn’s disease: a review. Am Surg. 2021;87(9):1361–7. https://doi.org/10.1177/0003134820956331. Epub 2020 Dec 19
Kelley KA, Kaur T, Tsikitis VL. Perianal Crohn's disease: challenges and solutions. Clin Exp Gastroenterol. 2017;10:39–46. https://doi.org/10.2147/CEG.S108513. PMID: 28223835; PMCID: PMC5308478
Kotze PG, Shen B, Lightner A, Yamamoto T, Spinelli A, Ghosh S, Panaccione R. Modern management of perianal fistulas in Crohn's disease: future directions. Gut. 2018;67(6):1181–94. https://doi.org/10.1136/gutjnl-2017-314918. Epub 2018 Jan 13
Zabot GP, Cassol O, Saad-Hossne R, Bemelman W. Modern surgical strategies for perianal Crohn's disease. World J Gastroenterol. 2020;26(42):6572–81. https://doi.org/10.3748/wjg.v26.i42.6572. PMID: 33268947; PMCID: PMC7673971
Gold SL, Cohen-Mekelburg S, Schneider Y, Steinlauf A. Perianal fistulas in patients with Crohn's disease, part 2: surgical, endoscopic, and future therapies. Gastroenterol Hepatol (N Y). 2018;14(9):521–8. PMID: 30364296; PMCID: PMC6194657
Adegbola SO, Pisani A, Sahnan K, Tozer P, Ellul P, Warusavitarne J. Medical and surgical management of perianal Crohn's disease. Ann Gastroenterol. 2018;31(2):129–39. https://doi.org/10.20524/aog.2018.0236. Epub 2018 Feb 8. PMID: 29507460; PMCID: PMC5825943
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
D’Angelo, T., Ascenti, G., Mazziotti, S., Cicero, G. (2022). MR Enterography: Anatomy. In: Mazziotti, S., Blandino, A., Cicero, G. (eds) MR Enterography. Springer, Cham. https://doi.org/10.1007/978-3-031-11930-9_4
Download citation
DOI: https://doi.org/10.1007/978-3-031-11930-9_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-11929-3
Online ISBN: 978-3-031-11930-9
eBook Packages: MedicineMedicine (R0)