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.
Similar content being viewed by others
References
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
Palder SB, Shandling B, Bilik R et al (1991) Perianal complications of pediatric Crohn’s disease. J Pediatr Surg 26:513–515
Markowitz J, Daum F, Aiges H et al (1984) Perianal disease in children and adolescents with Crohn’s disease. Gastroenterology 86:829–833
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
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
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
Wyllie R, Hyams JS (2006) Pediatric gastrointestinal and liver disease, 3rd edn. Saunders, Philadelphia
Hvas CL, Dahlerup JF, Jacobsen BA et al (2011) Diagnosis and treatment of fistulising Crohn’s disease. Dan Med Bull 58:C4338
McDermott S, Shenoy-Bhangle AS, Gee MS (2011) MRI of Crohn’s anoperineal disease. J Gastroint Dig Syst S9:001
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
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
Gasparetto M, Guariso G (2014) Crohn’s disease and growth deficiency in children and adolescents. World J Gastroenterol 20:13219–13233
Morris J, Spencer JA, Ambrose NS (2000) MR imaging classification of perianal fistulas and its implications for patient management. Radiographics 20:623–635
Parks AG, Gordon PH, Hardcastle JD (1976) A classification of fistula-in-ano. Br J Surg 63:1–12
Parks AG (1998) Pathogenesis and treatment of fistuila-in-ano [sic]. Br Med J 1:463–469
Halligan S, Stoker J (2006) Imaging of fistula in ano. Radiology 239:18–33
Compton GL, Bartlett M (2014) Perianal disease in pediatric Crohn disease: a review of MRI findings. Pediatr Radiol 44:1198–1208
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
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
McGee K (2003) The role of a child life specialist in a pediatric radiology department. Pediatr Radiol 33:467–474
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
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
McDonald RJ, McDonald JS, Kallmes DF et al (2015) Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 275:772–782
Aime S, Caravan P (2009) Biodistribution of gadolinium-based contrast agents, including gadolinium deposition. J Magn Reson Imaging 30:1259–1267
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
The authors have no financial interests, investigational or off-label uses to disclose.
Rights and permissions
About this article
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
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-016-3575-1