Crohn’s disease is an inflammatory condition chronic, relapsing and remitting, successfully treated with anti-TNF drugsin patients with severe active inflammation,even ifsometimes they can cause adverse reactions, leading to frequent surveillance of activity. MR-Enterography (D-CE-MRE) has been proven as an accepted method to assess Crohn’s Disease Activity, although it requires gadolinium contrast materials, which can produce some adverse effects. Recently, Diffusion-weighted MR imaging (DWI) has been used in multiple clinical condition, including bowel study and Crohn’s disease activity. Our aim is to define the value of...

We studied 77 patients with terminal ileum Crohn's disease(18-76 yrs, average 45,71 ys),without fasting,after bowel oral distension with polyethyleneglycol solution. We studied patients in supine position, with 1.5T MR scanner (Magnetom Avanto; Siemens, Erlangen, Germany) with high performing gradients (45 mT/m). We based MR-assessment of disease activity on: - dynamic motility,(cine-true-FISP on coronal plane) obtaining 10 images of the same slice in 7 seconds and dispensing 40 mg N-butyl-scopolamine i.v. (Buscopan; Boehringer, Ingelheim, Germany) to reduce bowel peristalsis; - basal study and DWI, through breath-hold...

As for as motility, we observed lack of Peristalsis in 23 Activeand in 2 Inactive cases,lack of Distensibility in 27 Active and 7 Inactive cases andpresence of Retrodilation in 5 Active and 2 Inactive patients. On DWI, Inflammatory bowel tracts showedhigher signal intensity compared to normal segments (Accuracy: 89,1%, Sensitivity: 89,7%, Specificity: 88,2%, PPV: 92,9%, NPV: 83,3).In quantitative assessment, ADC value in active disease was lower than in inactive disease (Negative: 1,9 x 10-3 ± 0,3 x 10-3 mm2/s, Inactive: 1,38 x 10-3± 0,26 x...

Valuable functional information about motility of affected loops and condition of proximal loops are allowed by cine-MR mode. Free-breathing-DWI gives some information in visual assessment of Crohn's disease activity; ADC values may facilitate quantitative analysis of disease activity, decreasing in inflamed bowel segments, because of restricted diffusion. It is achieved an accurate assessment of anatomy and Crohn's disease activity by an overall interpretation of MRI findings. So MR is crucial in the long-term management of patients with Crohn’s disease as it is FREE from IONIZING...

-Bell S, Kamm MA. Antibodies to tumour necrosis factor alpha as treatment for Crohn’s disease. Lancet 2000;355:858–860. -Targan SR et al. A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn’s disease. Crohn’s Disease cA2 Study Group. N Engl J Med 1997;337:1029–1035. -Maccioni F, Viscido A, Broglia L, et al. Evaluation of Crohn disease activity with magnetic resonance imaging. Abdom Imaging 2000; 25:219–228. - Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, Papamastorakis G, Prassopoulos P, Roussomoustakaki M. Assessment of Crohn’s disease...