MR enterography is a valuable tool in diagnosing inflammatory bowel diseases (Crohn's disease and ulcerative colitis), celiac disease, and chronic abdominal pain. It can detect disease, determine the extent of involvement, and differentiate between the active inflammatory phases of IBD and the chronic fibrosing component. Additionally, MR enterography can identify complications such as fistulae, abscesses, and associated conditions like sacroiliitis and biliary diseases.
Patient preparation
Most children over 6 years of age may undergo the exam without sedation. They should have nothing to eat 4 hours priors to the exam.
Exam request caveats
If there is concern for a peri-anal fistula, please comment specifically on the need to evaluate it.
References
Pearls and Pitfalls in MR Enterography Interpretation for Pediatric Patients. Harrington SG, Johnson MK, Greer M, Gee MS.Semin Ultrasound CT MR. 2020 Oct;41(5):462-471. doi: 10.1053/j.sult.2020.05.011. Epub 2020 May 28.PMID: 32980093
Examples
Example 1:
Very young child requiring sedation: Here since sedation child cannot drink, rectal contrast is administered to reflux into the small bowel. This allows for optimal bowel evaluation with significant reduction in anesthesia time.
Example 2:
Submucosal edema in the bowel wall (green arrow) is hallmark of active inflammation.
Example 3:
Sacroiliitis incidentally identified on an MR enterography exam.
