MR enteroclysis versus conventional enteroclysis inCrohn’s disease patients

Learning objectives: To provide a detailed step-by-step description of thetechnique of MR enteroclysis (MRE). To illustrate the spectrum of MRE findingsin patients with Crohn’s disease (CD) and their correlation with findings atconventional enteroclysis (CE). To discuss the advantages and limitations ofMRE in patients with CD.Background: CE is the gold standard for small bowel pathologies. However,submucosal and mesenteric involvements, which are common in CD, cannot beassessed by CE. Therefore, the evaluation of the mucosa alone by CE mayunder-represent the extent and activity of the disease. Also, CE is associatedwith the risk of several complications, mainly exacerbation in severe disease.MRE is a promising new modality that is useful in CD since it allows theassessment of mural and mesenteric changes.Imaging findings OR Procedure details: Between January 2007 and December2008, 48 patients with CD were submitted to MRE performed with a 1.5 T MRscan unit. All patients had undergone a previous CE. We report step-by-step themethodology MRE procedure, its technical aspects, strengths and weaknessesof each sequence, and future directions of the technique. MRC findings and theircorrelation with CE are illustrated and shown according to the type of CD usingCrohn’s disease activity index (CDAI) and pathology as referenced standard.Conclusion: MRE allows the evaluation of both CD activity and extramuralcomplications. MRE findings show a good correlation with CE. MRE can be afeasible alternative method to CE for assessing CD and its complications.