Skip to main content

Advertisement

Log in

Magnetic resonance imaging of perianal Crohn disease in children

  • Pediatric Body MRI
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Perianal penetrating complications of Crohn disease are among the most important causes of symptoms in the pediatric population. High-quality diagnostic imaging of the perianal region is crucial for treatment planning and therapeutic response assessment. MRI, with its absence of ionizing radiation and high soft-tissue resolution, provides an excellent noninvasive tool for evaluation of perianal fistulae and associated abscesses, as well as their anatomical relationship to the anal sphincter complex. In this review we discuss the role of MRI in initial diagnosis and follow-up of perianal fistulizing Crohn disease in the pediatric population.

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.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

Similar content being viewed by others

References

  1. Sandborn WJ, Fazio VW, Feagan BG et al (2003) American gastroenterological association clinical practice committee. AGA technical review on perianal Crohn’s disease. Gastroenterology 125:1508–1530

    Article  PubMed  Google Scholar 

  2. Palder SB, Shandling B, Bilik R et al (1991) Perianal complications of pediatric Crohn’s disease. J Pediatr Surg 26:513–515

    Article  CAS  PubMed  Google Scholar 

  3. Markowitz J, Daum F, Aiges H et al (1984) Perianal disease in children and adolescents with Crohn’s disease. Gastroenterology 86:829–833

    CAS  PubMed  Google Scholar 

  4. Keljo DJ, Markowitz J, Langton C et al (2009) Course and treatment of perianal disease in children newly diagnosed with Crohn’s disease. Inflamm Bowel Dis 15:383–387

    Article  PubMed  Google Scholar 

  5. Essary B, Kim J, Anupindi S et al (2007) Pelvic MRI in children with Crohn disease and suspected perianal involvement. Pediatr Radiol 37:201–208

    Article  PubMed  Google Scholar 

  6. Szurowska E, Wypych J, Izycka-Swieszewska E (2007) Perianal fistulas in Crohn’s disease: MRI diagnosis and surgical planning: MRI in fistulazing [sic] perianal Crohn’s disease. Abdom Imaging 32:705–718

    Article  PubMed  Google Scholar 

  7. Wyllie R, Hyams JS (2006) Pediatric gastrointestinal and liver disease, 3rd edn. Saunders, Philadelphia

    Google Scholar 

  8. Hvas CL, Dahlerup JF, Jacobsen BA et al (2011) Diagnosis and treatment of fistulising Crohn’s disease. Dan Med Bull 58:C4338

    PubMed  Google Scholar 

  9. McDermott S, Shenoy-Bhangle AS, Gee MS (2011) MRI of Crohn’s anoperineal disease. J Gastroint Dig Syst S9:001

    Google Scholar 

  10. Colombel JF, Schwartz DA, Sandborn WJ et al (2009) Adalimumab for the treatment of fistulas in patients with Crohn’s disease. Gut 58:940–948

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Present DH, Rutgeerts P, Targan S et al (1999) Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med 340:1398–1405

    Article  CAS  PubMed  Google Scholar 

  12. Gasparetto M, Guariso G (2014) Crohn’s disease and growth deficiency in children and adolescents. World J Gastroenterol 20:13219–13233

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Morris J, Spencer JA, Ambrose NS (2000) MR imaging classification of perianal fistulas and its implications for patient management. Radiographics 20:623–635

    Article  CAS  PubMed  Google Scholar 

  14. Parks AG, Gordon PH, Hardcastle JD (1976) A classification of fistula-in-ano. Br J Surg 63:1–12

    Article  CAS  PubMed  Google Scholar 

  15. Parks AG (1998) Pathogenesis and treatment of fistuila-in-ano [sic]. Br Med J 1:463–469

    Article  Google Scholar 

  16. Halligan S, Stoker J (2006) Imaging of fistula in ano. Radiology 239:18–33

    Article  PubMed  Google Scholar 

  17. Compton GL, Bartlett M (2014) Perianal disease in pediatric Crohn disease: a review of MRI findings. Pediatr Radiol 44:1198–1208

    Article  PubMed  Google Scholar 

  18. Shenoy-Bhangle AS, Nimkin K, Goldner D et al (2014) MRI predictors of treatment response for perianal fistulizing Crohn disease in children and young adults. Pediatr Radiol 44:23–29

    Article  PubMed  Google Scholar 

  19. Wilder RT, Flick RP, Sprung J et al (2009) Early exposure to anesthesia and learning disabilities in a population-based birth cohort. Anesthesiology 110:796–804

    Article  PubMed  PubMed Central  Google Scholar 

  20. McGee K (2003) The role of a child life specialist in a pediatric radiology department. Pediatr Radiol 33:467–474

    Article  PubMed  Google Scholar 

  21. Durand DJ, Young M, Nagy P et al (2015) Mandatory child life consultation and its impact on pediatric MRI workflow in an academic medical center. J Am Coll Radiol 12:594–598

    Article  PubMed  Google Scholar 

  22. Roberts DR, Holden KR (2015) Progressive increase of T1 signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images in the pediatric brain exposed to multiple doses of gadolinium contrast. Brain Dev. doi:10.1016/j.braindev.2015.08.009

    PubMed  Google Scholar 

  23. McDonald RJ, McDonald JS, Kallmes DF et al (2015) Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 275:772–782

    Article  PubMed  Google Scholar 

  24. Aime S, Caravan P (2009) Biodistribution of gadolinium-based contrast agents, including gadolinium deposition. J Magn Reson Imaging 30:1259–1267

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anuradha Shenoy-Bhangle.

Ethics declarations

Conflicts of interest

The authors have no financial interests, investigational or off-label uses to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shenoy-Bhangle, A., Gee, M.S. Magnetic resonance imaging of perianal Crohn disease in children. Pediatr Radiol 46, 838–846 (2016). https://doi.org/10.1007/s00247-016-3575-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-016-3575-1

Keywords

Navigation