Magnetic Resonance Enterography (MRE) in Crohn’s Disease: How We Do It and Common Imaging Findings

Abstract

Background: Crohn’s disease (CD) is a chronic inflammatory bowel disease that affects children and adults. MRE is the primary imaging technique for assessment due to its non-invasive characteristics and absence of ionizing radiation. MR enterography can identify both mural and extramural manifestations of CD, serving as a crucial tool for radiologists and clinicians in disease management.Methods: This cross-sectional study was conducted at outpatient clinics, the National Liver Institute, Menoufia University, and the Tropical Medicine Department at the Faculty of Medicine, Alexandria University, from January 2022 to December 2024. The study included 54 patients, aged 12 to 45 years, diagnosed with Crohn’s disease through colonoscopy findings. Results: All patients underwent MR enterography to evaluate various imaging features during active or complicated disease stages. Active bowel inflammation was characterized by bowel wall thickening in 46 patients (85%), bowel wall edema in 15 patients (27.8%), and mural wall hyperenhancement in 43 patients (79.6%). Inflammatory mesenteric fat stranding was detected in 41 patients (75.9%), mesenteric lymphadenopathy in 29 patients (53.7%), and vascular engorgement within the affected mesentery in 39 patients (72.2%). Fistula formation is a characteristic of penetrating disease, comprising two types: intra-abdominal fistulas in 9 patients (16.7%) and perianal fistulas in 11 patients (20.4%). Chronic bowel wall inflammation, which may progress to fibrostenotic complications, was observed in only two patients (3.7%). Conclusion: MR enterography is a pivotal diagnostic tool in assessing the typical imaging features of Crohn’s disease and its associated complications.