Role of MR enterography in crohn disease

In this study, we aimed to investigate the role of MR enterography in diagnosis or following of Crohn Disease that is one of the inflammatory bowel disease. MR enterography was performed in 42 cases (24 female, 18 male) who were referred from Gastroenterology Department with a prediagnosis of Crohn Disease between November 2013 and April 2014. Biphasic oral contrast agent was given to each patient following 12 hours fasting and bowel distension was supplied. In order to minimize artifacts due to bowel peristalsis, intravenous hyosine-n-butyl bromide (Buscopan, Boehringer Ilgelheim) was given to the patients. For the uncontrasted MR imaging coronal T2 SSh-TSE (Single Shot Turbo Spin Echo) was followed by coronal T1 SPIR (Spectral Presaturation Inversion Recovery), koronal T1 IP (In Phase), axial T1 IP and axial T1 SPIR sequens respectively. Then intravenous contrast agent was given as a bolus to each subject 40 seconds before the following MR imagings: coronal T1 SPIR, coronal T1 IP, axial T1 IP and axial T1 SPIR sequens. MR enterography and the contrast pattern was evaluated for the primary and secondary findings of active inflammation in bowel segments. Findings relevant with Crohn Disease was found in 26 bowel segments of 19 patients out of 42 subjects. These findings were as follows: jejunal involvement in 2 (%7,6) subjects, nonterminal ileum involvement in 2 (%7,6) subjects, terminal ileum involvement in 16 (%61,5) subjects, ascendant colon involvement, in 5 (%19,2) subjects, and sigmoid colon involvement in 1 (%3,8) subject. All involved bowel segments had active stage findings. In 18 (%69,2) bowel segments in 13 of 19 cases chronic stage findings were observed and these findings were found to be matched with Crohn Diseases activation. MR enterography is noninvasive imaging method which could be used in the diagnosis and follow up of patients with Crohn Disease due to fact that it provides valuable information about the activity of the diseases without posing any radioactive hazard. Therefore it's usage in current practice is increasing significantly. Key Words: Crohn Disease, MR enterography, Inflammatory Bowel Disease