TECHNIQUE: Multiplanar, multisequence MR Enterography of the abdomen and pelvis has been performed without and with intravenous contrast per departmental protocol.
COMPARISON: None.
FINDINGS:
Bowel (from stomach to anus):
Inflammation: Present/Absent
Bowel wall hyperenhancement: Present/Absent
Wall thickening (if present, is measured at the thickest portion of most distended segment or site of most severe inflammation): Mild (3-5 mm)/Moderate (5-9 mm)/Severe (≥10 mm)
Ulcerations: Present/Absent
Sacculations: Present/Absent
Stricture (if present, give location and length): Absent/Without upsteam dilation (probable stricture if one area remains narrowed on all sequences)/With mild upstream dilation (upstream lumen 3-4 cm)/With moderate to severe upstream dilation (upstream lumen > 4cm)
Penetrating complications (i.e. fistula, sinus tract, inflammatory mass, abscess): Present/Absent
Perianal disease: Present/Absent
Response to therapy: Compared to earlier exams to describe resolution or exacerbation of inflammatory findings
Tubes/Catheters/Devices: None.
Lower chest: Normal.
Liver: Normal.
Spleen: Normal.
Gallbladder and bile ducts: No findings of primary sclerosing cholangitis or cholelithiasis.
Pancreas: No findings of pancreatitis.
Peritoneal cavity, mesentery and omentum: Normal.
Adrenal glands: Normal.
Kidneys, ureters and urinary bladder: No findings of nephrolithiasis.
Reproductive organs: Female vs Male
Blood vessels: No findings of mesenteric vein occlusion or thrombosis.
Lymph nodes: No lymphadenopathy.
Skeleton and abdominal wall: No findings of avascular necrosis or sacroiliitis.
IMPRESSION:
Nonspecific small bowel inflammation/Active inflammatory small bowel/ Crohn's disease +/- luminal narrowing/Crohn's disease with no imaging signs of active inflammation/No imaging signs of small bowel inflammation.
Stricturing disease: Stricture with signs of active inflammation, specify length of stricture and degree of proximal obstruction/Stricture without signs of active inflammation, specify length and degree of proximal obstruction/Absent
Penetrating disease: Present/Absent.
Reference:
Bruining DH, Zimmermann EM, Loftus EV, Sandborn WJ, Sauer CG, Strong SA. Consensus Recommendations for Evaluation, Interpretation, and Utilization of Computed Tomography and Magnetic Resonance Enterography in Patients With Small Bowel Crohn’s Disease. Radiology. 2018;286(3):776-799. doi:10.1148/radiol.2018171737