MR Enterography

EXAM: MR Abdomen and Pelvis WITHOUT and WITH Contrast (MR Enterography)

INDICATION:      
COMPARISON: None available 

TECHNIQUE: Multiplanar and multisequence imaging was performed of the abdomen and pelvis without and with contrast. Axial T2 without fat sat, axial T2 with fat sat and coronal T2 weighted images.  Dynamic coronal T1 GRE fat sat images of the abdomen and pelvis were performed in precontrast, arterial, venous and delayed phases, after the subcutaneous injection of 1 mg of glucagon.  Postcontrast axial T1 GRE fat sat images of the abdomen and pelvis were also performed.

     IV Contrast: 20 mL of Dotarem gadolinium
     Oral Contrast: None
     Medications: None
            
COMPLICATIONS: None

FINDINGS:

SMALL BOWEL:
Active Inflammation:
Segmental mural hyperenhancement:    
Wall thickening:    
Intramural edema:     
Stricture:     
Ulcerations:     
Sacculations:    

Penetrating disease:
Sinus tract:    
Fistula:    
Inflammatory mass:    
Abscess:    
Free perforation:    

MESENTERIC FINDINGS:
Perienteric edema and/or inflammation:    
Engorged vasa recta:    
Fibrofatty proliferation:    
Mesenteric venous thrombosis and/or occlusion:    
Lymphadenopathy:    

STOMACH:    

COLON:    

APPENDIX:    

Presence of steatorrhea:     

BOWEL OBSTRUCTION:    

PERIANAL DISEASE: 
Abscess:    
Sinus/fistula:    


Radiologic concern for short bowel with further resection (length of small bowel left):    

Extra-GI Findings:
Lower thorax: No pleural effusion. 
Hepatobiliary:      No focal hepatic lesions. No biliary ductal dilation. 
Gallbladder: No stones or sludge.  No wall thickening.
Spleen: No splenomegaly. 
Pancreas: No focal masses or ductal dilatation.  
Adrenals: No adrenal nodules    
Kidneys: Kidneys enhance symmetrically.  No hydronephrosis. No cystic or solid mass lesions.  No stones.
Lymph nodes: No lymphadenopathy.
Vessels: Unremarkable.
Peritoneum / Retroperitoneum: No free air or fluid.
Bones: Unremarkable.
SOFT TISSUES: Unremarkable.            

IMPRESSION:

Inflammation impression statement:    

Stricture Impression Statement:    

Penetrating Crohn Disease Impression Statement:    

Perianal Crohn Disease Impression statement:    

Other Complications Impression Statement:    


Reference: Bruining DH, Zimmermann EM, Loftus EV Jr et al. Consensus recommendations for evaluation, interpretation, and utilization of computed tomography and magnetic resonance enterography in patients with small bowel Crohn’s disease. Gastroenterology 2018;154(4):1172–1194.