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Cross-sectional Imaging in Crohn Disease¹

¹ From the Departments of Radiology (A.F., M.Y., K. Maeda, N.N., M.T., K. Murata) and Gastroenterology (T. Saotome, T.T., Y.F.), Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu Shiga 520-2192, Japan; and the Department of Radiology, Koga Public Hospital, Koga, Japan (T. Sakamoto). Recipient of a Certificate of Merit award for an education exhibit at the 2002 RSNA scientific assembly. Received April 29, 2003; revision requested June 19 and received September 5; accepted September 5. All authors have no financial relationships to disclose. Address correspondence to A.F. (e-mail: akira@belle.shiga-med.ac.jp).

The role of cross-sectional imaging in the diagnosis of Crohn disease has expanded with recent technologic advances in computed tomography (CT) and magnetic resonance (MR) imaging that allow rapid acquisition of high-resolution images of the intestines. To acquire images of diagnostic quality, administration of a fairly large amount of intraluminal contrast agent prior to examination and scanning with intravenous contrast material injection are necessary. Both CT and MR imaging are reported to have a sensitivity of over 95% for the detection of Crohn disease; however, they may not allow early diagnosis. Colonoscopy and conventional enteroclysis studies are indicated for patients with early-stage disease. At more advanced stages, CT and MR imaging can help identify and characterize pathologically altered bowel segments as well as extraluminal lesions (eg, fistulas, abscesses, fibrofatty proliferation, increased vascularity of the vasa recta, mesenteric lymphadenopathy). These modalities can also clearly depict inflammatory lesion activity and conditions that require elective gastrointestinal surgery, thereby aiding in treatment planning. In the clinical setting, CT is currently the imaging modality of choice at most institutions; however, it is expected that MR imaging will soon play a comparable role. CT or MR imaging should be included in a comprehensive evaluation of patients with Crohn disease, along with conventional imaging and clinical and laboratory tests.

© RSNA, 2004

Index Terms: Crohn disease, 70.262 • Enteritis, 74.24, 74.262 • Ileum, 742.262 • Intestines, CT, 74.1211 • Intestines, diseases, 74.24, 74.262 • Intestines, MR, 74.1214

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