Skip to main content

MR Enterography and CT Enterography for Detecting Activity and Complications

  • Chapter
  • First Online:
Cross-Sectional Imaging in Crohn’s Disease

Abstract

In patients with inflammatory bowel disease, CT and MR have become the radiological methods of choice in the assessment of disease activity, severity and extension, complementary to endoscopy and biopsy. These radiological tools have the ability to evaluate bowel wall changes, location, extent and can detect extramural complications such as fistulae and abscesses. These radiological findings are important to determine the therapeutic strategy and also have prognostic implications.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ordàs I, Rimola J, Rodriguez S, Paredes JM, Martinez-Pérez MJ, Blanc E, Arévalo JA, Aduna M, Andreu M, Radosevic A, Ramirez-Morros AM, Pino S, Gallego M, Jauregui-Amezaga A, Ricart E, Panés J. Accuracy of magnetic resonance enterography in assessing response to therapy and mucosal healing in patients with Crohn’s disease. Gastroenterology. 2014;146:374–82.

    Article  Google Scholar 

  2. Colombel JF, Rutgeerts PJ, Sandborn WJ, Yang M, Camez A, Pollack PF, Thakkar RB, Robinson AM, Chen N, Mulani PM, Chao J. Adalimumab induces deep remission in patients with Crohn’s disease. Clin Gastroenterol Hepatol. 2014;12:414–22.

    Article  CAS  Google Scholar 

  3. Baert F, Moortgat L, Van Assche G, Caenepeel P, Vergauwe P, De Vos M, Stokkers P, Hommes D, Rutgeerts P, Vermeire S, D’Haens G. Mucosal healing predicts sustained clinical remission in patients with early-stage Crohn’s disease. Gastroenterology. 2010;138:463–8.

    Article  Google Scholar 

  4. Jauregui-Amezaga A, Rimola J, Ordàs I, Rodrigquez S, Ramirez-Morros A, Gallego M, Masamunt MC, Llach J, Gonzàlez-Suàrez B, Ricart E, Panés J. Value of endoscopy and MRI for predicting intestinal surgery in patients with Crohn’s disease in the era of biologics. Gut. 2015;64:1397–402.

    Article  CAS  Google Scholar 

  5. Huprich JE, Fletcher JG. CT enterography: principles, technique and utility in Crohn’s disease. Eur J Radiol. 2009;69:393–7.

    Article  Google Scholar 

  6. Leyendecker JR, Bloomfeld RS, DiSantis DJ, Waters GS, Mott R, Bechtold RE. MR enterography in management of patients with Crohn disease. Radiographics. 2009;29:1827–46.

    Article  Google Scholar 

  7. Rimola J, Rodriguez S, Cabanas ML, Ayuso C, Panés J, Cuatrecasas M. MRI of Crohn’s disease: from imaging to pathology. Abdom Imaging. 2012;37:387–96.

    Article  Google Scholar 

  8. Tolan DJM, Greenhalgh R, Zealley IA, Halligan S, Taylor SA. MR enterographic manifestations of small bowel Crohn disease. Radiographics. 2010;30:367–84.

    Article  Google Scholar 

  9. Bruining DH, Zimmermann EM, Loftus EV Jr, Sandborn WJ, Sauer CG, Strong SA; Society of Abdominal Radiology Crohn’s Disease-Focused Panel. Consensus recommendations for evaluation, interpretation, and utilization of computed tomography and magnetic resonance enterography in patients with small bowel Crohn’s disease. Gastroenterology. 2017. pii: S0016-5085(17)36658-1.

    Google Scholar 

  10. Hara EK, Swartz PG. CT enterography of Crohn’s disease. Abdom Imaging. 2009;34:289–95.

    Article  Google Scholar 

  11. Park MJ, Lim JS. Computed tomography enterography for evaluation of inflammatory bowel disease. Clin Endosc. 2013;46(4):327–66.

    Article  Google Scholar 

  12. Takenaka K, Ohtsuka K, Kitazume Y, Nagahori M, Fujii T, Saito E, Naganuma M, Araki A, Watanabe M. Comparison of magnetic resonance and balloon enteroscopic examination of the small intestine in patients with Crohn’s disease. Gastroenterology. 2014;147:334–42.

    Article  Google Scholar 

  13. Takenaka K, Ohtsuka K, Kitazume Y, Nagahori M, Fujii T, Saito E, Fujioka T, Matsuoka K, Naganuma M, Watanabe M. Correlation of the endoscopic and magnetic resonance scoring systems in the deep small intestine in Crohn’s disease. Inflamm Bowel Dis. 2015;2(8):1832–8.

    Article  Google Scholar 

  14. Gale HI, Sharatz SM, Taphey M, Bradley WF, Nimkin K, Gee MS. Comparison of CT enterography and MR enterography imaging features of active Crohn disease in children and adolescents. Pediatr Radiol. 2017;47:1321–8.

    Article  Google Scholar 

  15. Choi SH, Kim KW, Lee JY, Kim KJ, Lee JY, Kim KJ, Park SH. Diffusion-weighted magnetic resonance enterography for evaluating bowel inflammation in Crohn’s disease: a systematic review and meta-analysis. Inflamm Bowel Dis. 2016;22(3):669–79.

    Article  Google Scholar 

  16. Dohan A, Taylor S, Hoeffel C, Barret M, Allez M, Dautry R, Zappa M, Savoye-Collet C, Dray X, Boudiaf M, Reinhold C, Soyer P. J Magn Reson Imaging. 2016;44:1381–96.

    Article  Google Scholar 

  17. Sato H, Tamura C, Narimatsu K, Shimizu M, Takajyo T, Yamashita M, Inoue Y, Ozaki H, Furuhashi H, Maruta K, Yasutake Y, Yoshikawa K, Watanabe C, Komoto S, Tomita K, Nagao S, Miura S, Shinmoto H, Hokari R. Magnetic resonance enterocolonography in detecting erosion and redness in intestinal mucosa of patients with Crohn’s disease. J Gastroenterol Hepatol. 2015;30:667–73.

    Article  Google Scholar 

  18. Oussalah A, Laurent V, Bruot O, Bressenot A, Bigard MA, Régent D, Peyrin-Biroulet L. Diffusion-weighted magnetic resonance without bowel preparation for detecting colonic inflammation in inflammatory bowel disease. Gut. 2010;59:1056–65.

    Article  Google Scholar 

  19. Rimola J, Alvarez-Cofino A, Pérez-Jeldres T, Rodriguez S, Alfaro I, Ordàs I, Ricart E, Panés J. Increasing efficiency of MRE for diagnosis of Crohn’s disease activity through proper sequence selection: a practical approach for clinical trials. Abdom Radiol. 2017;42(12):2783–91.

    Article  Google Scholar 

  20. Allen BC, Leyendecker JR. MR enterography for assessment and management of small bowel Crohn disease. Radiol Clin North Am. 2014;52:799–810.

    Article  Google Scholar 

  21. Li X, Mao R, Huang S, Sun C, Cao Q, Fang Z, Zhang Z, Huang L, Lin J, Chen Y, Rimola J, Rieder F, Chen M, Feng S, Li Z. Characterization of degree of intestinal fibrosis in patients with Crohn disease by using magnetization transfer MR imaging. Radiology. 2018;000:1–10.

    Google Scholar 

  22. Erden A, Ünal S, Akkaya HE, Onay M, Törüner M, Gençtürk ZB, Kartal AC. MR enterography in Crohn’s disease complicated with enteroenteric fistula. Eur J Radiol. 2017;94:101–6.

    Article  Google Scholar 

  23. Liu W, Liu J, Xiao W, Luo G. A diagnostic accuracy meta-analysis of CT and MRI for the evaluation of small bowel Crohn disease. Acad Radiol. 2017;24:1216–25.

    Article  Google Scholar 

  24. Greenup AJ, Bressler B, Rosenfeld G. Medical imaging in small bowel Crohn’s disease-computer tomography enterography, magnetic resonance enterography, and ultrasound: which one is the best for what? Inflamm Bowel Dis. 2016;22(5):1246–61.

    Article  Google Scholar 

  25. Rimola J, Rodriguez S, Garcia-Bosch O, Ordas I, Ayala E, Aceituno M, Pellisé M, Ayuso C, Ricart E, Donoso L, Panés J. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn’s disease. Gut. 2009;58:1113–20.

    Article  CAS  Google Scholar 

  26. Rimola J, Ordas I, Rodriguez S, Garcia-Bosch O, Aceituno M, Llach J, Ayuso C, Ricart E, Panés J. Magnetic resonance imaging for evaluation of Crohn’s disease: validation of parameters of severity and quantitative index of activity. Inflamm Bowel Dis. 2011;17(8):1759–68.

    Article  Google Scholar 

  27. Deepak P, Fletcher JG, Fidler JL, Barlow JM, Sheedy SP, Kolbe AB, Harmsen WS, Loftus EV, Hansel SL, Becker BD, Bruining DH. Radiological response is associated with better long-term outcomes and is a potential treatment target in patients with small bowel Crohn’s disease. Am J Gastroenterol. 2016;111:997–1006.

    Article  Google Scholar 

  28. Panaccione R, Colombel JF, Louis E, Peyrin-Biroulet L, Sandborn WJ. Evolving definitions of remission in Crohn’s disease. Inflamm Bowel Dis. 2013;19(8):1645–53.

    Article  Google Scholar 

  29. Reinink AR, Lee TC, Higgins PDR. Endoscopic mucosal healing predicts clinical outcomes in inflammatory bowel disease: a meta-analysis. Inflamm Bowel Dis. 2016;22:1859–69.

    Article  Google Scholar 

  30. Bruining DH, Loftus EV, Ehman EC, Siddiki HA, Nguyen DL, Fidler JL, Huprich JE, Mandrekar JN, Harmsen WS, Sandborn WJ, Fletcher JG. Computed tomography enterography detects intestinal wall changes and effects of treatment in patients with Crohn’s disease. Clin Gastroenterol Hepatol. 2011;9:679–83.

    Article  Google Scholar 

  31. Wu YW, Tang YH, Hao NX, Tang CY, Miao F. Crohn’s disease: CT enterography manifestations before and after treatment. Eur J Radiol. 2012;81:52–9.

    Article  Google Scholar 

  32. Stoppino LP, Della Valle N, Rizzi S, Cleopazza E, Centola A, Iamele D, Bristogiannis C, Stoppino G, Vinci R, Macarini L. Magnetic resonance enterography changes after antibody to tumor necrosis factor (anti-TNF) alpha therapy in Crohn’s disease: correlation with SES-CD and clinical-biological markers. BMC Med Imaging. 2016;16(1):37.

    Article  Google Scholar 

  33. Takenaka K, Ohtsuka K, Kitazume Y, Matsuoka K, Nagahori M, Fujii T, Saito E, Kimura M, Fujioka T, Watanabe M. Utility of magnetic resonance enterography for small bowel endoscopic healing in patients with Crohn’s disease. Am J Gastroenterol. 2017;464:1–12.

    Google Scholar 

Download references

Acknowledgment

Special thanks to Mrs. Elly O’Connor.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ragna Vanslembrouck .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Vanslembrouck, R. (2019). MR Enterography and CT Enterography for Detecting Activity and Complications. In: Rimola, J. (eds) Cross-Sectional Imaging in Crohn’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-96586-4_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-96586-4_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-96585-7

  • Online ISBN: 978-3-319-96586-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics