Assessment of Crohn’s disease activity in the small bowel with MR enteroclysis: clininico-radiological correlations.

Background: The aim of our study was to evaluate the accuracy of magnetic resonance imaging (MRI) in evaluating Crohn disease (CD) activity compared to clinical/laboratory data. Methods: Ninety-three consecutive patients with CD were prospectively studied by MR imaging, before and after Gadolinium chelates administration, with use of a biphasic endoluminal contrast agent. MR image analysis included: number of lesions, presence/absence of bowel stenosis, upstream bowel dilation, wall thickness, presence of enhancement, enhancement pattern, presence/ absence of comb sign, lymph nodes, and perianal fistulas/abscesses. Clinical evaluation was performed by means of Harvey & Bradshaw Index. Acute-phase reactants were considered standard of reference to monitor biological activity (BA). MR imaging findings were compared with clinical and laboratory data. Results: MR image analysis detected: In 96 exams multiple lesions in 16, 1 in 50; no lesions in 30; stenosis in 52; dilatation in 28; wall thickening in 59; significant enhancement in 57; layered pattern in 50; comb sign in 37; enlarged lymph nodes in 16; fibro-fatty proliferation in 40; fistulas in 9. Conclusions: MRI is able to depict morphological changes and is helpful in assessing Crohn inflammatory disease.