Update on MR Enterography: Potentials and Pitfalls

Ryan B. O’Malley, Neil J. Hansen, Jonathan Carnell, Anita Afzali, Mariam Moshiri

Research output: Contribution to journalReview article

Abstract

Purpose of Review: This article serves to review the role of MR Enterography (MRE) in current clinical practice. Optimal technique is described based on recent consensus guidelines, as well as the potential role of optional and emerging sequences. The value of MRE for assessing patients with inflammatory bowel disease (IBD) is highlighted, including diagnosis, disease subtyping, detecting extraintestinal findings, and identifying complications, including particular attention to how these findings may be used for treatment decision-making. We specifically address the advantages and disadvantages of MRE compared to CT Enterography, including recently updated American College of Radiology Appropriateness Criteria for Crohn disease. Although less well established, we also discuss the utility of MRE in evaluating noninflammatory small bowel pathologies. Recent Findings: Beyond initial diagnosis and disease phenotype characterization, MRE is increasingly incorporated into clinical indices used for treatment decision-making and assessing bowel damage longitudinally. Detecting and quantifying fibrosis remains a challenge in imaging for IBD, but some MRE sequences, such as magnetization transfer (MT) imaging, or fusion modalities, such as PET/MRE, have shown promise in providing functional information and offering meaningful biomarkers. MRE is also increasingly utilized for applications outside of IBD, such as screening for or assessing small bowel neoplasms. Summary: MRE is a valuable noninvasive technique for imaging the entire gastrointestinal tract and extraintestinal organs in a single examination without ionizing radiation. In IBD, MRE allows for accurate initial diagnosis and subtyping by assessing the bowel lumen, bowel wall, and surrounding structures simultaneously. Reliably predicting and quantifying fibrosis remains a challenge, but novel techniques, including fusion PET/MRE and MT imaging, offer promise. Quantitative MRE indices have also been developed and validated for assessing treatment response in patients with IBD, which can help guide treatment toward mucosal healing.

Original languageEnglish (US)
Article number42
JournalCurrent Radiology Reports
Volume4
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

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Keywords

  • Crohn disease
  • Enterography
  • Gastrointestinal
  • Inflammatory bowel disease
  • Magnetic resonance imaging
  • Ulcerative colitis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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