Learning objectives
The purpose of this report is to review radiographic features in entero-MRI of Crohn Disease in pediatric age patients and to set forth the differences with the Ulcerous Colitis (CU),
as well as to expose the protocol and patient preparation that we perform in our hospital.
Background
Crohn disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases.
CD extends togastrointestinal tractdiscontinuously,the entire bowel wall is involved and ulcers extends deep into the bowel wall predisposing to fistulae.
Ulcerative colitispredominantly affectsthecolon,
justmucosa and submucosa are affected and chronic disease is associated with a significantly elevated malignancy risk.
The lack of ionising radiation from MRI would become a better option to confirm diagnosis and follow-up in children,
however,
the availability and expertise of MRI is limited in many countries.
Findings and procedure details
MR is playing an increasing role in the evaluation of gastrointestinal disorders.
MRI combines the advantages of excellent softtissue contrast,
noninvasiveness,
functional information and lack of ionizing radiation.
Furthermore,
recent developments of MRI have led to improved spatial and temporal resolution as well as decreased motion artifacts.
1.
INDICATIONS
The MR enterography,
is most often used to evaluate inflammatory bowel disease (IBD) and particulary is useful in assessing the degree inflammatory activity.
Also,
MR enterography allows evaluation of the bowel lumen and wall,
adjacent mesentery...
Conclusion
The lack of ionising radiation from MRI is a better option to confirm CD and its follow up with children.
Despite of endoscopic findings are the gold standard to confirm and evaluate complications in CU,
MRE can differentiate from EC and it is useful to demonstrate extension and acute inflammation.
References
1.
Mollard BJ,
Smith EA,DillmanJR.Pediatric MRenterography: techniqueandapproachtointerpretation-howwedoit.
Radiology.
2015 Jan;274(1):29-43.
2.
MRenterography: how to deliver added value.
Jonathan R.Dillman,
Andrew T.
Trout,
Ethan A.
Smith.PediatricRadiology 2016 Mar 3.
DOI 10.10007/s00247-016-3555-5.
3.
The Role of MREnterographyin Assessing Crohn´s Disease Activity and Treatment Response.MatthesP.
Moy,
Jenny Sauk,
Michael S.
Gee.
Gastroenterology Research and Practice.Volume2016 (2016),ArticleID 8168695,
13pages.
4.
Assessment of Magnetic ResonanceEnterographyin the Diagnosis of Small Bowell Disease in Children with Crohn´s Disease.
Barbara M.Iwanczak,Ewa Nienartowicz,
Elzbieta Krzesiek.
AdvClin Exp Med 2016,
25,
1,
111-115.
5.
Pediatric...