Skip to main content

Advertisement

Log in

MR enterography in Crohn’s disease: current consensus on optimal imaging technique and future advances from the SAR Crohn’s disease-focused panel

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

MR enterography is a powerful tool for the non-invasive evaluation of patients with Crohn’s disease (CD) without ionizing radiation. The following paper describes the current consensus on optimal imaging technique, interpretation, and future advances from the Society of Abdominal Radiology CD-focused panel.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Jaffe TA, Gaca AM, Delaney S, et al. (2007) Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohn’s disease. Am J Roengenol 189:1015–1102

    Article  Google Scholar 

  2. Kroeker KI, Lam S, Birchall I, et al. (2011) Patients with IBD are exposed to high levels of ionizing radiation through CT scan diagnostic imaging: a five year study. J Clin Gastroenterol 45:34–39

    Article  PubMed  Google Scholar 

  3. Fucic A, Brunborg G, Lasan R, et al. (2008) Genomic damage in children accidentally exposed to ionizing radiation: a review of the literature. Mutat Res 658:111–123

    Article  CAS  PubMed  Google Scholar 

  4. Huang JS, Tobin A, Harvey L, et al. (2001) Diagnostic medical radiation in pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 53(5):502–506

    Article  Google Scholar 

  5. Sauer CG, Kugathasan S, Martin DR, et al. (2011) Medical radiation exposure in children with inflammatory bowel disease estimates high cumulative doses. Inflamm Bowel Dis 17(11):2326–2332

    Article  PubMed  Google Scholar 

  6. Guimaraes LS, Fidler JL, Fletcher JG, et al. (2010) Assessment of appropriateness of indications for CT enterography in younger patients. Inflamm Bowel Dis 16(2):226–232

    Article  PubMed  Google Scholar 

  7. Fiorino G, Bonifacio C, Peyrin-Biroulet L, et al. (2011) Prospective comparison of computed tomography enterography and magnetic resonance enterography for assessment of disease activity and complications in ileocolonic Crohn’s disase. Inflamm Bowel Dis 17(5):1073–1080

    Article  CAS  PubMed  Google Scholar 

  8. Ordás I, Rimola J, Rodríguez S, et al. (2014) Accuracy of magnetic resonance enterography in assessing response to therapy and mucosal healing in patients with Crohn’s disease. Gastroenterology 146(2):374–382

    Article  PubMed  Google Scholar 

  9. Quencer KB, Nimkin K, Mino-Kenudson M, et al. (2013) Detecting active inflammation and fibrosis in pediatric Crohn’s disease: prospective evaluation of MR-E and CT-E. Abdom Imaging 38(4):705–713

    Article  PubMed Central  PubMed  Google Scholar 

  10. Oto A, Kayhan A, Williams JT, et al. (2011) Active Crohn’s disease in the small bowel: evaluation by diffusion weighted imaging and quantitative dynamic contrast enhanced MR imaging. J Magn Reson Imaging 33:615–624

    Article  PubMed  Google Scholar 

  11. Bickelhaupt S, Froehlich JM, Cattin R, et al. (2013) Differntiation between active and chronic Crohn’s disease using MRI small-bowel motility examinations—initial experience. Clin Radiol 68(12):1247–1253

    Article  CAS  PubMed  Google Scholar 

  12. Adler J, Swanson S, Schmiedlin-Ren P, et al. (2011) Magnetization transfer helps detect intestinal fibrosis in an animal model of Crohn disease. Radiology 259:127–135

    Article  PubMed Central  PubMed  Google Scholar 

  13. Szurowska E, Wypch J, Izycka-Swieszewska E (2007) Perianal fistulas in Crohn’s disease: MRI diagnosis and surgical planning. Abdom Imaging 32(6):705–718

    Article  PubMed  Google Scholar 

  14. Baker ME, Einstein DM, Veniero JC (2008) Computed tomography enterography and magnetic resonance enterography: the future of small bowel imaging. Clin Colon Rectal Surg 21(3):193–212

    Article  PubMed Central  PubMed  Google Scholar 

  15. Cronin CG, Lohan DG, Mhuircheartaigh JN (2008) MRI small-bowel follow-through: prone versus supine patient positioning for best small-bowel distension and lesion detection. Am J Roengenol 191:502–506

    Article  Google Scholar 

  16. Ajaj W, Goyen M, Schneeman H, et al. (2005) Oral contrast agents for small bowel distension in MRI: influence of the osmolarity for small bowel distension. Eur Radiol 15:1400–1406

    Article  PubMed  Google Scholar 

  17. Borthne AS, Abdelnoor M, Hellund JC, et al. (2005) MR imaging of the small bowel with increasing concentrations of an oral osmotic agent. Eur Radiol 15:667–671

    Article  Google Scholar 

  18. Negaard A, Sandivik L, Berstad AE, et al. (2007) A prospective randomized comparison between two MRI studies of the small bowel in Crohn’s disease, the oral contrast method and MRE enteroclysis. Eur Radiol 17:2294–2301

    Article  PubMed  Google Scholar 

  19. Negaard A, Sandvik L, Berstad AE, et al. (2008) MRI of the small bowel with oral contrast or nasojejunal intubation in Crohn’s disease: randomized comparison of patient acceptance. Scand J Gastroenterol 43:44–51

    Article  PubMed  Google Scholar 

  20. Ajaj W, Lauenstein TC, Langhorst J, et al. (2005) Small bowel hydro-MR imaging for optimized ileocecal distension in Crohn’s disease: should an additional rectal enema filling be performed? J Magn Reson Imaging 22(1):92–100

    Article  PubMed  Google Scholar 

  21. Grand DJ, Beland MD, Machan JT, et al. (2012) Detection of Crohn’s disease: comparison of CT and MR enterography without anti-peristaltic agents performed on the same day. Eur J Radiol 81(8):1735–1741

    Article  PubMed  Google Scholar 

  22. Grand DJ, Kampalath V, Harris A, et al. (2012) MR enterography correlates highly with colonoscopy and histology for both distal ileal and colonic Crohn’s disease in 310 patients. Eur J Radiol 81(5):e763–e769

    Article  PubMed  Google Scholar 

  23. Al-Hawary M, Zimmermann EM (2012) A new look at Crohn’s disease: novel imaging techniques. Curr Opin Gastroenterol 28(4):334–340

    PubMed  Google Scholar 

  24. Sandrasegaran K (2014) Functional MR imaging of the abdomen. Radiol Clin North Am 52(4):883–903

    Article  PubMed  Google Scholar 

  25. Oto A, Kayhan A, Williams JT, et al. (2011) Active Crohn’s disease in the small bowel: evaluation by diffusion weighted imaging and quantitative dynamic contrast enhanced MR imaging. J Magn Reson Imaging 33(3):615–624

    Article  PubMed  Google Scholar 

  26. Ream JM, Dillman JR, Adler J, et al. (2013) MRI diffusion-weighted imaging (DWI) in pediatric small bowel Crohn disease: correlation with MRI findings of active bowel wall inflammation. Pediatr Radiol 43(9):1077–1085

    Article  PubMed  Google Scholar 

  27. Hordonneau C, Buisson A, Scanzi J, et al. (2014) Diffusion-weighted magnetic resonance imaging in ileocolonic Crohn’s disease: validation of quantitative index of activity. Am J Gastroenterol 109(1):89–98

    Article  CAS  PubMed  Google Scholar 

  28. Adler J, Swanson SD, Schmiedlin-Ren P, et al. (2011) Magnetization transfer helps detect intestinal fibrosis in an animal model of Crohn disease. Radiology 259(1):127–135

    Article  PubMed Central  PubMed  Google Scholar 

  29. Wakamiya M, Furukawa A, Kanasaki S, et al. (2011) Assessment of small bowel motility function with cine-MRI using balanced steady-state free precession sequence. J Magn Reson Imaging 33:1235–1240

    Article  PubMed  Google Scholar 

  30. Froehlich JM, Patek MA, von Weymarn C, et al. (2005) Small bowel motility assessment with magnetic resonance imaging. J Magn Reson Imaging 21:370–375

    Article  PubMed  Google Scholar 

  31. Odille F, Menys A, Ahmed A, et al. (2012) Quantitative assessment of small bowel motility by nonrigid registration of dynamic MR images. Magn Reson Med 68(3):783–793

    Article  PubMed  Google Scholar 

  32. Heye T, Stein D, Antolovic D, et al. (2012) Evaluation of bowel peristalsis by dynamic cine MRI: detection of relevant functional disturbances—initial experience. J Magn Reson Imaging 35:859–867

    Article  PubMed  Google Scholar 

  33. Siddiki H, Fidler J (2009) MR imaging of the small bowel in Crohn’s disease. Eur J Radiol 69:409–417

    Article  PubMed  Google Scholar 

  34. Fletcher JG, Fidler JL, Bruining DH, et al. (2011) New concepts in intestinal imaging for inflammatory bowel diseases. Gastroenterology 140:1795–1806

    Article  PubMed  Google Scholar 

  35. Lee S, Ha H, Yang S, et al. (2002) CT of prominent pericolic or perienteric vasculature in patients with Crohn’s disease: correlation with clinical disease activity and findings on barium studies. Am J Roengenol 179:1029–1036

    Article  Google Scholar 

  36. Koh DM, Miao Y, Chinn RJS (2001) MR imaging evaluation of the activity of Crohn’s disease. Am J Roengenol 177:1325–1332

    Article  CAS  Google Scholar 

  37. Sempere GAJ, Sanjuan VM, Chulia EM, et al. (2005) MRI evaluation of inflammatory activity in Crohn’s disease. Am J Roengenol 184:1829–1835

    Article  Google Scholar 

  38. Rimola J, Rodriguez S, Garcia-Bosch O, et al. (2009) Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn’s disease. Gut 58:1113–1120

    Article  CAS  PubMed  Google Scholar 

  39. Maccioni F, Bruni A, Viscido A, et al. (2006) 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. Radiology 238(2):517–530

    Article  PubMed  Google Scholar 

  40. Adler J, Punglia DR, Dillman JR, et al. (2012) Computed tomography enterography findings correlate with tissue inflammation, not fibrosis in resected small bowel Crohn’s disease. Inflamm Bowel Dis 18(5):849–856

    Article  PubMed  Google Scholar 

  41. Rieder F, Fiocchi C (2009) Intestinal fibrosis in IBD—a dynamic, multifactorial process. Nat Rev Gastroenterol Hepatol 6:228–235

    Article  CAS  PubMed  Google Scholar 

  42. Messaris E, Chandolias N, Grand DJ, et al. (2010) Role of magnetic resonance enterography in the management of Crohn disease. Arch Surg 145(5):471–475

    Article  PubMed  Google Scholar 

  43. Gee MS, Nimkin K, Hsu M, et al. (2011) Prospective evaluation of MR enterography as the primary imaging modality for pediatric Crohn’s disease assessment. Am J Roengenol 197(1):224–231

    Article  Google Scholar 

  44. Pozza A, Scarpa M, Lacognata C, et al. (2011) Magnetic resonance enterography for Crohn’s disease: what the surgeon can take home. J Gastrointest Surg 15:1689–1698

    Article  PubMed  Google Scholar 

  45. Smith EA, Dillman JR, Adler J (2012) MR enterography of extraluminal manifestations of inflammatory bowel disease in children and adolescents: moving beyond the bowel wall. Am J Roengenol 198:W38–W45

    Article  Google Scholar 

  46. Rimola J, Ordas I, Rodriguez S, et al. (2011) Magnetic resonance imaging for evaluation of Crohn’s disease: validation of parameters of severity and quantitative index of activity. Inflamm Bowel Dis 17:1759–1768

    Article  PubMed  Google Scholar 

  47. Lawrance IC, Welman CJ, Shipman P, et al. (2009) Correlation of MRI-determined small bowel Crohn’s disease categories with medical response and surgical pathology. World J Gastroenterol 15(27):3367–3375

    Article  PubMed Central  PubMed  Google Scholar 

  48. Steward MJ, Punwani S, Proctor I, et al. (2012) Non-perforating small bowel Crohn’s disease assessed by MRI enterography: derivation and histopathological validation of an MR-based activity index. Eur J Radiol 81:2080–2088

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David J. Grand.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MP4 2938 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Grand, D.J., Guglielmo, F.F. & Al-Hawary, M.M. MR enterography in Crohn’s disease: current consensus on optimal imaging technique and future advances from the SAR Crohn’s disease-focused panel. Abdom Imaging 40, 953–964 (2015). https://doi.org/10.1007/s00261-015-0361-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-015-0361-8

Keywords

Navigation