Clinical Radiology
Volume 64, Issue 4 , Pages 341-352 , April 2009

Role of MRI in Crohn's disease

  • R. Sinha

      Affiliations

    • Department of Radiology, GI Unit, South Warwickshire NHS Trust, & IBD Network, Coventry & South Warwickshire, United Kingdom
    • Corresponding Author InformationGuarantor and correspondent: R. Sinha, Department of Clinical Radiology, Warwick Hospital, Lakin Road, Warwick CV34 5BW, UK. Tel.: +01-92-649-5321; fax: +01-92-648-2612.
  • ,
  • P. Murphy

      Affiliations

    • Department of Surgery, GI Unit, South Warwickshire NHS Trust, & IBD Network, Coventry & South Warwickshire, United Kingdom
  • ,
  • P. Hawker

      Affiliations

    • Department of Gastroenterology, GI Unit, South Warwickshire NHS Trust, & IBD Network, Coventry & South Warwickshire, United Kingdom
  • ,
  • S. Sanders

      Affiliations

    • Department of Pathology, GI Unit, South Warwickshire NHS Trust & IBD Network, Coventry & South Warwickshire, United Kingdom
  • ,
  • A. Rajesh

      Affiliations

    • Department of Radiology, University Hospitals of Leicester, Leicester, UK
  • ,
  • R. Verma

      Affiliations

    • Department of Radiology, University Hospitals of Leicester, Leicester, UK

Received 7 July 2008 ,Revised 18 August 2008 ,Accepted 20 August 2008.

References 

  1. Maglinte D, Gourtsoyiannis N, Rex D, et al. Classification of small bowel Crohn's subtypes based on multimodality imaging. Radiol Clin North Am. 2003;41:285–303
  2. Fleischer DE, Grimm IS, Friedman LS. Inflammatory bowel disease in older patients. Med Clin North Am. 1994;78:1303–1319
  3. Przemioslo RT, Ciclitira PJ. Pathogenesis of Crohn's disease. QJM. 1995;88:525–527
  4. Halligan S, Nicholls S, Bartram CI, et al. The distribution of small bowel Crohn's disease in children compared to adults. Clin Radiol. 1994;49:314–316
  5. Wills JS, Lobis IF, Denstman FJ. Crohn disease: state of the art. Radiology. 1997;202:597–610
  6. Richards ME, Rickert RR, Nance FC. Crohn's disease-associated carcinoma. A poorly recognized complication of inflammatory bowel disease. Ann Surg. 1989;209:764–773
  7. Ribeiro MB, Greenstein AJ, Sachar DB, et al. Colorectal adenocarcinoma in Crohn's disease. Ann Surg. 1996;223:186–193
  8. Glick SN, Teplick SK, Goodman LR, et al. Development of lymphoma in patients with Crohn disease. Radiology. 1984;153:337–339
  9. Kelly IM, Bartram CI. Pseudotumoral appearance of small bowel strictureplasty for Crohn's disease. Abdom Imaging. 1993;18:366–368
  10. Masselli G, Brizi G, Parrella A, et al. Crohn disease: magnetic resonance enteroclysis. Abdom Imaging. 2004;29:326–334
  11. Chou CK, Chen LT, Sheu RS, et al. MRI manifestations of gastrointestinal wall thickening. Abdom Imaging. 1994;19:389–394
  12. Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, et al. Assessment of Crohn's disease activity in the small bowel with MR and conventional enteroclysis: preliminary results. Eur Radiol. 2004;14:1017–1024
  13. Gourtsoyiannis N, Grammatikakis J, Papamastorakis G, et al. Imaging of small intestinal Crohn's disease: comparison between MR enteroclysis and conventional enteroclysis. Eur Radiol. 2006;16:1915–1925
  14. Darbari A, Sena L, Argani P, et al. Gadolinium-enhanced magnetic resonance imaging: a useful radiological tool in diagnosing pediatric IBD. Inflamm Bowel Dis. 2004;10:67–72
  15. Low RN, Francis IR. MR imaging of the gastrointestinal tract with i.v., gadolinium and diluted barium oral contrast media compared with unenhanced MR imaging and CT. AJR Am J Roentgenol. 1997;169:1051–1059
  16. Maccioni F. Current status of gastrointestinal MRI. Abdom Imaging. 2002;27:358–360
  17. Maglinte D, Chernish S, Kelvin F, et al. Crohn disease of the small intestine: accuracy and relevance of enteroclysis. Radiology. 1992;184:541–545
  18. Marcos HB, Semelka RC. Evaluation of Crohn's disease using half-fourier RARE and gadolinium-enhanced SGE sequences: initial results. Magn Reson Imaging. 2000;18:263–268
  19. Semelka RC, Shoenut JP, Silverman R, et al. Bowel disease: prospective comparison of CT and 1.5-T pre- and postcontrast MR imaging with T1-weighted fat-suppressed and breath-hold FLASH sequences. J Magn Reson Imaging. 1991;1:625–632
  20. Prassopoulos P, Papanikolaou N, Grammatikakis J, et al. MR enteroclysis imaging of Crohn disease. RadioGraphics. 2001;21:S161–S172
  21. Laghi A, Borrelli O, Paolantonio P, et al. Contrast enhanced magnetic resonance imaging of the terminal ileum in children with Crohn's disease. Gut. 2003;52:393–397
  22. Masselli G, Casciani E, Polettini E, et al. Assessment of Crohn's disease in the small bowel: prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis. Eur Radiol. 2006;16:2817–2827
  23. Horsthuis K, Bipat S, Bennink RJ, et al. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology. 2008;247:64–79
  24. Horsthuis K, Stokkers P, Stoker J. Detection of inflammatory bowel disease: diagnostic performance of cross-sectional imaging modalities. Abdom Imaging. 2008;33:417–424
  25. Ryan ER, Heaslip ISE. Magnetic resonance enteroclysis compared with conventional enteroclysis and computed tomography enteroclysis: a critically appraised topic. Abdom Imaging. 2008;33:34–37
  26. Umschaden HW, Szolar D, Gasser J, et al. Small-bowel disease: comparison of MR enteroclysis images with conventional enteroclysis and surgical findings. Radiology. 2000;215:717–725
  27. Frøkjaer JB, Larsen E, Steffensen E, et al. Magnetic resonance imaging of the small bowel in Crohn's disease. Scand J Gastroenterol. 2005;40:832–842
  28. Schmidt S, Lepori D, Meuwly J, et al. Prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis: interobserver agreement and sensitivity by means of “sign-by-sign” correlation. Eur Radiol. 2003;13:1303–1311
  29. Hassan C, Cerro P, Zullo A, et al. Computed tomography enteroclysis in comparison with ileoscopy in patients with Crohn's disease. Int J Colorectal Dis. 2003;18:121–125
  30. Minordi LM, Vecchioli A, Guidi L, et al. Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease. Eur Radiol. 2006;16:1527–1536
  31. Wold PB, Fletcher JG, Johnson CD, et al. Assessment of small bowel Crohn disease: noninvasive peroral CT enterography compared with other imaging methods and endoscopy—feasibility study. Radiology. 2003;229:275–281
  32. Hara AK, Leighton AJ, Heigh RI, et al. Crohn's disease of the small bowel: preliminary comparison between CT enterography, capsule endoscopy, small bowel follow-through, and ileoscopy. Radiology. 2006;238:128–134
  33. Koelbel G, Schmiedl U, Majer MC, et al. Diagnosis of fistulae and sinus tracts in patients with Crohn disease: value of MR imaging. AJR Am J Roentgenol. 1989;152:999–1003
  34. Albert JG, Martiny F, Krummenerl A, et al. Diagnosis of small bowel Crohn's disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut. 2005;54:1721–1727
  35. Triester SL, Leighton JA, Leontiadis GI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn's disease. Am J Gastroenterol. 2006;101:954–964
  36. Maglinte D, Sandrasegaran K, Chiorean M, et al. Radiologic investigations complement and add diagnostic information to capsule endoscopy of small-bowel diseases. AJR Am J Roentgenol. 2007;189:306–312
  37. Sandrasegaran K, Maglinte DDT, Jennings SG, et al. Capsule endoscopy and imaging tests in the elective investigation of small bowel disease. Clin Radiol. 2008;63:712–723
  38. Seiderer J, Herrmann K, Diepolder H, et al. Double-balloon enteroscopy versus magnetic resonance enteroclysis in diagnosing suspected small-bowel Crohn's disease: results of a pilot study. Scand J Gastroenterol. 2007;42:1376–1385
  39. Fraquelli M, Colli A, Casazza G, et al. Role of US in detection of Crohn disease: meta-analysis. Radiology. 2005;236:95–101
  40. Cucchiara S, Celentano L, de Magistris TM, et al. Colonoscopy and technetium-99m white cell scan in children with suspected inflammatory bowel disease. J Pediatr. 1999;135:727–732
  41. Dhôte R, Beades E, Le Dinh T, et al. Scintigraphy using leukocytes marked with 99m-Tc-HMPAO in Crohn's disease, Acta Gastroenterol Belg. 1995;58:353–363
  42. Almer S, Granerus G, Ström M, et al. Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohn's disease. Inflamm Bowel Dis. 2007;13:164–174
  43. Rispo A, Imbriaco M, Celentano L, et al. Small bowel Crohn's disease: comparison of enteroclysis, bowel sonography and Tc-99m-HMPAO leukocyte scintigraphy. Eur Rev Med Pharmacol Sci. 2004;8:219–224
  44. Giaffer MH. Labelled leucocyte scintigraphy in inflammatory bowel disease: clinical applications. Gut. 1996;38:1–5
  45. Mansfield JC, Giaffer MH, Tindale WB, et al. Quantitative assessment of overall inflammatory bowel disease activity using labelled leucocytes: a direct comparison between indium-111 and technetium-99m HMPAO methods. Gut. 1995;37:679–683
  46. Sciarretta G, Furno A, Mazzoni M, et al. Technetium-99m hexamethyl propylene amine oxime granulocyte scintigraphy in Crohn's disease: diagnostic and clinical relevance. Gut. 1993;34:1364–1369
  47. Louis E, Ancion G, Colard A, et al. Noninvasive assessment of Crohn's disease intestinal lesions with (18)F-FDG PET/CT. J Nucl Med. 2007;48:1053–1059
  48. Madsen SM, Thomsen HS, Munkholm P, et al. Inflammatory bowel disease evaluated by low-field magnetic resonance imaging. Comparison with endoscopy, 99mTc-HMPAO leucocyte scintigraphy, conventional radiography and surgery. Scand J Gastroenterol. 2002;37:307–316
  49. Neurath MF, Vehling D, Schunk K, et al. Noninvasive assessment of Crohn's disease activity: a comparison of 18F-fluorodeoxyglucose positron emission tomography, hydromagnetic resonance imaging, and granulocyte scintigraphy with labeled antibodies. Am J Gastroenterol. 2002;97:1978–1985
  50. Desmond AN, O'Regan K, Curran C, et al. Crohn's disease: factors associated with exposure to high levels of diagnostic radiation. Gut. 2008;
  51. Kuehle C, Ajaj W, Ladd S, et al. Hydro-MRI of the small bowel: effect of contrast volume, timing of contrast administration, and data acquisition on bowel distention. AJR Am J Roentgenol. 2006;187:375–385
  52. Lomas DJ, Graves MJ. Small bowel MRI using water as a contrast medium. Br J Radiol. 1999;72:994–997
  53. Patak MA, Froehlich JM, von Weymarn C, et al. Non-invasive distension of the small bowel for magnetic-resonance imaging. Lancet. 2001;358:987–988
  54. Ajaj W, Goehde SC, Schneemann H, et al. Dose optimization of mannitol solution for small bowel distension in MRI. J Magn Reson Imaging. 2004;20:648–653
  55. Lohan D, Cronin C, Meehan C, et al. MR small bowel enterography: optimization of imaging timing. Clin Radiol. 2007;62:804–807
  56. Negaard A, Paulsen V, Sandvik L, et al. A prospective randomized comparison between two MRI studies of the small bowel in Crohn's disease, the oral contrast method and MR enteroclysis. Eur Radiol. 2007;17:2294–2301
  57. Negaard A, Sandvik L, Berstad AE, et al. MRI of the small bowel with oral contrast or nasojejunal intubation in Crohn's disease: randomized comparison of patient acceptance. Scand J Gastroenterol. 2008;43:44–51
  58. Godefroy C, Pilleul F, Dugougeat F, et al. Value of contrast-enhanced MR enterography in pediatric Crohn's disease: preliminary study, J Radiol. 2005;86:1685–1692
  59. Pilleul F, Godefroy C, Yzebe-Beziat D, et al. Magnetic resonance imaging in Crohn's disease. Gastroenterol Clin Biol. 2005;29:803–808
  60. Hohl C, Haage P, Krombach GA, et al. Diagnostic evaluation of chronic inflammatory intestinal diseases in children and adolescents: MRI with true-FISP as new gold standard?. Rofo. 2005;177:856–863
  61. Rieber A, Aschoff A, Nüssle K, et al. MRI in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis. Eur Radiol. 2000;10:1377–1382
  62. Narin B, Ajaj W, Göhde S, et al. Combined small and large bowel MR imaging in patients with Crohn's disease: a feasibility study. Eur Radiol. 2004;14:1535–1542
  63. Röttgen R, Herzog H, Lopez-Hänninen E, et al. Combination of dynamic MR enteroclysis (Sellink) and MR colonography to diagnose Crohn's disease. Rofo. 2005;177:1131–1138
  64. Shoenut JP, Semelka RC, Silverman R, et al. Magnetic resonance imaging in inflammatory bowel disease. J Clin Gastroenterol. 1993;17:73–78
  65. Negaard A, Sandvik L, Mulahasanovic A, et al. Magnetic resonance enteroclysis in the diagnosis of small-intestinal Crohn's disease: diagnostic accuracy and inter- and intra-observer agreement. Acta Radiol. 2006;47:1008–1016
  66. Sempere G, Martinez Sanjuan V, Medina Chulia E, et al. MRI evaluation of inflammatory activity in Crohn's disease. AJR Am J Roentgenol. 2005;184:1829–1835
  67. Koh D, Miao Y, Chinn R, et al. MR imaging evaluation of the activity of Crohn's disease. AJR Am J Roentgenol. 2001;177:1325–1332
  68. Del Vescovo R, Sansoni I, Caviglia R, et al. Dynamic contrast enhanced magnetic resonance imaging of the terminal ileum: differentiation of activity of Crohn's disease. Abdom Imaging. 2007;33:417–424
  69. Florie J, Wasser M, Arts-Cieslik K, et al. Dynamic contrast-enhanced MRI of the bowel wall for assessment of disease activity in Crohn's disease. AJR Am J Roentgenol. 2006;186:1384–1392
  70. Low R, Sebrechts C, Politoske D, et al. Crohn disease with endoscopic correlation: single-shot fast spin-echo and gadolinium-enhanced fat-suppressed spoiled gradient-echo MR imaging. Radiology. 2002;222:652–660
  71. Pauls S, Gabelmann A, Schmidt SA, et al. Evaluating bowel wall vascularity in Crohn's disease: a comparison of dynamic MRI and wideband harmonic imaging contrast-enhanced low MI ultrasound. Eur Radiol. 2006;16:2410–2417
  72. Koutroubakis IE, Tsiolakidou G, Karmiris K, et al. Role of angiogenesis in inflammatory bowel disease. Inflamm Bowel Dis. 2006;12:515–523
  73. Maccioni F, Bruni A, Viscido A, et al. MR imaging in patients with Crohn disease: value of T2- versus T1-weighted gadolinium-enhanced MR sequences with use of an oral superparamagnetic contrast agent. Radiology. 2006;238:517–530
  74. Desreumaux P, Ernst O, Geboes K, et al. Inflammatory alterations in mesenteric adipose tissue in Crohn's disease. Gastroenterology. 1999;117:73–81
  75. Peyrin-Biroulet L, Chamaillard M, Gonzalez F, et al. Mesenteric fat in Crohn's disease: a pathogenetic hallmark or an innocent bystander?. Gut. 2007;56:577–583
  76. Bell SJ, Williams AB, Wiesel P, et al. The clinical course of fistulating Crohn's disease. Aliment Pharmacol Ther. 2003;17:1145–1151
  77. Herrmann K, Michaely H, Zech C, et al. Internal fistulas in Crohn disease: magnetic resonance enteroclysis. Abdom Imaging. 2006;31:675–687
  78. Schwartz DA, Loftus EV, Tremaine WJ, et al. The natural history of fistulizing Crohn's disease in Olmsted County, Minnesota. Gastroenterology. 2002;122:875–880
  79. Schreyer AG, Geissler A, Albrich H, et al. Abdominal MRI after enteroclysis or with oral contrast in patients with suspected or proven Crohn's disease. Clin Gastroenterol Hepatol. 2004;2:491–497
  80. Gervais DA, Hahn PF, O'Neill MJ, et al. Percutaneous abscess drainage in Crohn disease: technical success and short- and long-term outcomes during 14 years. Radiology. 2002;222:645–651
  81. Michelassi F, Balestracci T, Chappell R, et al. Primary and recurrent Crohn's disease. Experience with 1379 patients. Ann Surg. 1991;214:230–238
  82. Bernell O, Lapidus A, Hellers G. Risk factors for surgery and recurrence in 907 patients with primary ileocaecal Crohn's disease. Br J Surg. 2000;87:1697–1701
  83. Szurowska E, Wypych J, Izycka-Swieszewska E. Perianal fistulas in Crohn's disease: MRI diagnosis and surgical planning: MRI in fistulazing perianal Crohn's disease. Abdom Imaging. 2007;32:705–718
  84. Rasul I, Wilson SR, MacRae H, et al. Clinical and radiological responses after infliximab treatment for perianal fistulizing Crohn's disease. Am J Gastroenterol. 2004;99:82–88
  85. Van Assche G, Vanbeckevoort D, Bielen D, et al. Magnetic resonance imaging of the effects of infliximab on perianal fistulizing Crohn's disease. Am J Gastroenterol. 2003;98:332–339
  86. Patak MA, von Weymarn C, Froehlich JM. Small bowel MR imaging: 1.5T versus 3T. Magn Reson Imaging Clin N Am. 2007;15:383–393
  87. Hohl C, Honnef D, Krombach G, et al. Pediatric bowel MRI — accelerated parallel imaging in a single breathhold. Rofo. 2008;180:402–409
  88. Sinha R, Nwokolo C, Murphy PD. Magnetic resonance imaging in Crohn's disease. BMJ. 2008;336:273–276

PII: S0009-9260(08)00363-2

doi: 10.1016/j.crad.2008.08.006

Clinical Radiology
Volume 64, Issue 4 , Pages 341-352 , April 2009