MR enteroclysis versus conventional enteroclysis in Crohn’s disease patients

Abstract

Learning objectives: To provide a detailed step-by-step description of the technique of MR enteroclysis (MRE). To illustrate the spectrum of MRE findings in patients with Crohn’s disease (CD) and their correlation with findings at conventional enteroclysis (CE). To discuss the advantages and limitations of MRE in patients with CD. Background: CE is the gold standard for small bowel pathologies. However, submucosal and mesenteric involvements, which are common in CD, cannot be assessed by CE. Therefore, the evaluation of the mucosa alone by CE may under-represent the extent and activity of the disease. Also, CE is associated with the risk of several complications, mainly exacerbation in severe disease. MRE is a promising new modality that is useful in CD since it allows the assessment of mural and mesenteric changes. Imaging findings OR Procedure details: Between January 2007 and December 2008, 48 patients with CD were submitted to MRE performed with a 1.5 T MR scan unit. All patients had undergone a previous CE. We report step-by-step the methodology MRE procedure, its technical aspects, strengths and weaknesses of each sequence, and future directions of the technique. MRC findings and their correlation with CE are illustrated and shown according to the type of CD using Crohn’s disease activity index (CDAI) and pathology as referenced standard. Conclusion: MRE allows the evaluation of both CD activity and extramural complications. MRE findings show a good correlation with CE. MRE can be a feasible alternative method to CE for assessing CD and its complications.