Magnetic Resonance Enterography (MRE) in Crohn’s Disease: How We Do It and Common Imaging Findings

Document Type : Original Clinical

Authors

1 Radiology department, National Liver Institute, Menoufia University, Egypt.

2 Department of Pediatric Hepatology, Gastroenterology and Nutrition, National Liver Institute, Menoufia University, Egypt.

3 Tropical Medicine Department, Faculty of Medicine, Alexandria University, Egypt.

Abstract

Background: Crohn’s disease (CD) is a chronic inflammatory bowel disease that affects children and adults. MRE is the primary imaging technique for assessment due to its non-invasive characteristics and absence of ionizing radiation. MR enterography can identify both mural and extramural manifestations of CD, serving as a crucial tool for radiologists and clinicians in disease management.
Methods: This cross-sectional study was conducted at outpatient clinics, the National Liver Institute, Menoufia University, and the Tropical Medicine Department at the Faculty of Medicine, Alexandria University, from January 2022 to December 2024. The study included 54 patients, aged 12 to 45 years, diagnosed with Crohn’s disease through colonoscopy findings. 
Results: All patients underwent MR enterography to evaluate various imaging features during active or complicated disease stages. Active bowel inflammation was characterized by bowel wall thickening in 46 patients (85%), bowel wall edema in 15 patients (27.8%), and mural wall hyperenhancement in 43 patients (79.6%). Inflammatory mesenteric fat stranding was detected in 41 patients (75.9%), mesenteric lymphadenopathy in 29 patients (53.7%), and vascular engorgement within the affected mesentery in 39 patients (72.2%). Fistula formation is a characteristic of penetrating disease, comprising two types: intra-abdominal fistulas in 9 patients (16.7%) and perianal fistulas in 11 patients (20.4%). Chronic bowel wall inflammation, which may progress to fibrostenotic complications, was observed in only two patients (3.7%). 
Conclusion: MR enterography is a pivotal diagnostic tool in assessing the typical imaging features of Crohn’s disease and its associated complications. 

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Footnotes. Ahmed Fathy (Professor of internal medicine, gastroenterology, and hepatology unit), Mohamed Emara (professor of gastroenterology, hepatology, and infectious diseases), Emad Emara (assistant professor of radiology), and Amany Mohamed (professor of family medicine, biostatistician) were the peer reviewers. E- Editor: Salem Youssef Mohamed, Osama Ahmed Khalil, Amany Mohammed. Copyright ©. This open-access article is distributed under the Creative Commons Attribution License (CC BY). It may be used, distributed, or reproduced in other forums, provided the original author(s) and the copyright owner(s) are credited. The original publication in this journal must be cited according to accepted academic practice. Disclaimer: The authors' claims in this article are solely their own and do not necessarily represent their affiliated organizations or those of the publisher, the editors, and the reviewers. Any product evaluated in this article or its manufacturer's claim is not guaranteed or endorsed by the publisher. Ethical approval: All procedures followed were by the ethical standards of the responsible committee on human experimentation (Institutional Review Board (IRB)) of National Liver Institute, Menoufia University, and with the Helsinki Declaration of 1964 and later versions. The committee’s reference number is NLI IRB 00014014/FWA00034015. Informed consent was obtained before commencing the study. Study protocol: In adherence to the principles outlined in the Helsinki Declaration, the study protocol was implemented with approval from the institutional review board. Before commencing the research, written consent was obtained to utilize their clinical information. Data and materials availability: The datasets used or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests: The authors declare that they have no competing interests. Funding: This study had no funding from any source. This work was done according to the STROBE guidelines. Authors' contributions RAA, MAA, and RAM wrote the research, selected the research cases, prepared the figures for case demonstration, and reviewed the study. MSA, assess cases for initial diagnosis. HSE assesses case selection and carries out cases on the workstation. “All authors read and approved the final manuscript.” Acknowledgment: none.

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