Magnetic resonance enterography guiding treatment in children with Crohn's jejunoileitis

Acta Paediatr. 2012 Jun;101(6):631-6. doi: 10.1111/j.1651-2227.2012.02607.x. Epub 2012 Feb 7.

Abstract

Aim: To determine the usefulness of magnetic resonance enterography (MRE) in treatment for paediatric patients with Crohn's disease.

Methods: To evaluate small bowel involvement, 45 children with Crohn's disease were scheduled for MRE. Two radiologists blinded to the patient data independently re-evaluated the images. Findings in images were compared to macroscopic findings at surgery or endoscopy.

Results: The terminal ileum was visualized in all with a completed procedure (43/45). The treatment remained conservative in 74% after imaging. In all 13 patients who underwent ileocolonoscopy within 3 months of MRE, the MRE findings were comparable with the macroscopic findings or revealed a more extensive disease. Bowel resection was performed in 26% after imaging. The macroscopic findings in the bowel corresponded to the MRE findings in 73%. In three MRE suggested a more severe disease than was verified intraoperatively.

Conclusions: Magnetic resonance enterography identifies disease involvement in the small bowel in young patients with Crohn's disease and may guide decisions on the need for intestinal surgery or adjustment of medication.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Colonoscopy
  • Crohn Disease / diagnosis*
  • Crohn Disease / therapy*
  • Enteritis / diagnosis
  • Enteritis / therapy
  • Female
  • Humans
  • Ileitis / diagnosis
  • Ileitis / therapy
  • Jejunal Diseases / diagnosis
  • Jejunal Diseases / therapy
  • Magnetic Resonance Imaging*
  • Male