Digestive Diseases and Sciences

, Volume 64, Issue 1, pp 204–212 | Cite as

Creeping Fat Assessed by Small Bowel MRI Is Linked to Bowel Damage and Abdominal Surgery in Crohn’s Disease

  • Patrick Althoff
  • Wolff Schmiegel
  • Gernot Lang
  • Volkmar Nicolas
  • Thorsten BrechmannEmail author
Original Article



Crohn’s disease (CD) leads to bowel damage and surgery in a significant proportion of patients.


The aim of the study was to evaluate the predictive value of creeping fat assessed by small bowel MRI in CD patients.


CD patients undergoing small bowel MRI were included in a retrospective observational cohort study. Clinical findings were extracted and correlated with radiological outcome measures. Logistic regression analysis was performed to assess predictors associated with a complicated course and surgery within 2 years and long-term follow-up.


Ninety patients (49% female, median follow-up 93 months) were included. Creeping fat was identified in 21.1%. Of these patients, 68% and 79% developed bowel damage (p < .05) and 42% and 63% of patients revealing creeping fat underwent surgery within 2 years following MRI and total follow-up, respectively. The presence of creeping fat [odds ratio (OR) 4.0], inflammatory stenosis (OR 3.7), multisegmental (small) bowel (OR 4.5 and 3.8), and proximal small bowel inflammation (OR 5.0) were associated with inferior outcome (p < .05) in a univariate analysis. Creeping fat was independently associated with a disabling course, bowel damage, and surgery (OR 3.5 each, p < .05) in a multivariate analysis model.


Creeping fat identified by small bowel MRI is associated with a complicated course and abdominal surgery in CD. Our data adds evidence that small bowel MRI facilitates risk stratification in order to define a patient at risk of disease-related complications in CD. [DRKS00011727,].


Bowel damage Small bowel MRI Prediction of outcome Creeping fat 



We gratefully thank Marlies Kersting-Schwarz for the assistance regarding the collection of MRI studies, Michaela Meyburg for her help throughout the study and, last, but not least, Igors Iesalnieks for discussing the data and reviewing the manuscript.

Author’s contribution

PA conducted the study, acquired the data, performed analysis and interpretation, and drafted the manuscript. Prof. Dr. WS supervised the study, revised the manuscript, and provided support in terms of gastroenterology. Prof. Dr. VN supervised the study, revised the manuscript, and provided support in terms of small bowel MRI. Dr. GL acquired the data and revised the manuscript. Dr. TB conceived and designed the study, analyzed and interpreted the data, supervised the study, and drafted the manuscript. All authors approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no actual or potential conflict of interest.

Supplementary material

10620_2018_5303_MOESM1_ESM.pdf (363 kb)
Supplementary material 1 (PDF 363 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gastroenterology and HepatologyBerufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Ruhr-University BochumBochumGermany
  2. 2.Department of MedicineUniversitätsklinikum Knappschaftskrankenhaus Bochum GmbHBochumGermany
  3. 3.Department of Orthopedic and Trauma SurgeryUniversity Medical Center FreiburgFreiburgGermany
  4. 4.Diagnostic and Interventional RadiologyBerufsgenossenschaftliche Universitätsklinik Bergmannsheil Bochum gGmbHBochumGermany

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