Learning objectives
To analyze the correct MR enterography (MRE) protocols for Crohn disease (CD) in pediatric patients,
emphasizing their protocol preparation
To highlight the most frequent MRI findings of CD at onset
Background
Inflammatory Bowel Disease (IBD) includes Crohn disease,
ulcerative colitis and unclassified IBD.
Incidence of IBD is increasing worldwide with wide geographic variability.
A systematic review demonstrates an incidence of 12.7 per 100000 person-years in Europe,
5.0 per 100000 person-years in Asia and the Middle East,
20.2 per 100000 person-years in North America.
Pediatric CD occurs in up to 25% of patients,
often of greater severity than adult IBD.
5% of all IBD patients are children younger than 10 years old and less than 1% is...
Findings and procedure details
MRI can be considered a challenge for radiologists,
especially in pediatric patients because it requires accurate preparation and great collaboration from the patient before and during the exam.
Moreover in younger children,
parental participation is essential to achieve greater compliance.
It is important to explain the methods of examination and the function of an adequate preparation.
In our experience their presence is fundamental to reassure the child and to administer the oral contrast.
For the preparation patients should not eat any solid food and drink...
Conclusion
Pediatric MRE is an important tool in CD diagnosis.
It allows evaluation of the entire bowel without ionizing radiations.
The major limits to this technique are the importance of keeping a strict adherence to the preparation protocol (usually hard to obtain in young children) and the length of the actual exam.
References
-Müller,
K.
E.,
Lakatos,
P.
L.,
Papp,
M.,
& Veres,
G.
Incidence and Paris Classification of Pediatric Inflammatory Bowel Disease,
2014.
-Bruining D.H.,
Zimmermann,
E.
M.,
et al.(2018).
Consensus recommendations for evaluation,
interpretation and Utilization of Computed Tomography and Magnetic Resonance Enterography in Patients With Small Bowel,
2018 286(3).
-Allimant,
C.,
Obritin-guilhen,
H.,
& Bommelaer,
G.
(2018).
in Crohn ’ s disease.
Digestive and Liver Disease,
(2017).
-Maccioni,
F.,
Al Ansari,
Mazzamuro F.,
Civitelli F,
Viola F.,
Cucchiara S.,
Catalano C.
Detection of Crohn Disease...