WHEN CROHN’S COMES TO RADIOLOGIST- THE ROLE OF MR ENTEROGRAPHY (MRE) IN THE DIAGNOSIS OF PENETRATING CROHN’S DISEASE IN PEDIATRIC AND ADULT PATIENTS

Crohn’s disease is a chronic inflammatory disease of the gastrointestinal tract. The typical clinical scenario is a young patient presenting with abdominal pain, chronic diarrhea and fatigue. The diagnosis is typically made with endoscopic and/or radiologic findings. Nowadays, non-invasive imaging examination (like MRE) plays an increasingly important role. AIM The aim of the study is to assess the usefulness of the MRE in the diagnosis and monitoring of penetrating Crohn’s disease in comparison to adult and pediatric patients. METHODS The study included 146 adults (82 women and 64 men) and 23 pediatric patients (10 boys, 13 girls) diagnosed with Crohn’s disease, who underwent MRE with intravenous administration of a contrast agent. All MRE findings were further confirmed by colonoscopy, or intraoperatively if applicable. RESULTS In the adult group 30 fistulas were identified: 6 complex perianal, 16 simple intestinal (7 blind and 9 ileo-colonic) and 8 complex intestinal (3 ileo-cecal and 5 ileo-colonic). Peri-intestinal abscesses were observed in 9 patients. In the pediatric group in 5 patients small intestine fistulas were found, whereas abscess was observed in another 5 patients. In 12 children inflammatory infiltration of peri-intestinal fat was depicted. CONCLUSION In MRE, we can observe the entire intestinal wall, which allows for an accurate assessment of changes in the digestive system. Our research shows that the incidence of Crohn’s disease complications differs between adult and pediatric patients - perianal abscesses are diagnosed more often in children, while peri-intestinal location is more common in adults. The presence of fistulas was found with the same frequency in both study groups.