MR enterography can be valuable in the diagnosis of inflammatory bowel disease (Crohn's disease and ulcerative colitis), celiac disease, and chronic abdominal pain.
MR enterography can
- detect disease,
- determine the extent of involvement,
- distinguish between the active inflammatory phases of IBD from the chronic fibrosing component
- identify complications, such as fistulae, abscesses
- identify associated sacroiliitis and biliary diseases
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.
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
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.
Submucosal edema in the bowel wall (green arrow) is hallmark of active inflammation.
Sacroiliitis incidentally identified on an MR enterography exam.