The Spectrum of Magnetic Resonance Enterography Findings and the Role of Diffusion-Weighted Imaging in Patients with Active Crohn’s Disease

Abstract

Background: The goal of this study was to evaluate magnetic resonance enterography (MRE) findings and assess the role of diffusion-weighted imaging (DWI) in patients suffering from active Crohn’s disease. Methods: This retrospective study included a total number of 76 patients diagnosed with active Crohn’s disease, as established by the Crohn’s Disease Activity Index (CDAI). The study consisted of 30 women and 46 men, ranging in age from 13 to 72 years. All participants underwent MRE with DWI sequences. The study was conducted at Imam Khomeini hospital in Tehran between 2013 and 2018. The imaging modality utilized for the study included a 3-T SIGNA Excite MRE machine and a Siemens Magnetom 3-T magnetic resonance imaging (MRI) machine. Results: Bowel wall restriction was observed in less than half of the patients, and no significant correlation was found with extramural findings such as mesenteric edema. The study did not reveal any meaningful association between diffusion restriction and specific mural enhancement patterns, mesenteric lymphadenopathy with or without enhancement, or the length of the affected segments (P>0.05). The most common findings observed in MRI were ileum thickness in 72.4% of patients, mesenteric lymphadenopathy without enhancement in 46.1%, ileocecal thickness in 42.1%, DWI findings in 42.1%, the presence of a comb sign in 36.8%, and jejunum thickness in 30.3% of patients. Conclusion: MRE findings are useful in the evaluation of Crohn’s disease activity.