Evaluation of Crohn's disease using half-fourier RARE and gadolinium-enhanced SGE sequences: initial results

To assess the bowel changes in Crohn's disease, 11 consecutive patients underwent magnetic resonance imaging (MRI) study using T(2)-weighted half-Fourier rapid acquisition with relaxation enhancement (RARE) and gadolinium-enhanced standard and fat suppressed spoiled gradient echo (SGE) sequences. Comparison was made between MR findings of disease extent, severity, and complications and clinical data, endoscopic findings and/or surgical specimens in all patients. We found that the half-Fourier RARE images showed bowel wall thickening, dilatation of bowel and bowel obstruction well in all patients, however severity of bowel disease could not be determined as the signal intensity of diseased bowel was comparable to normal bowel in 10/11 patients. Gadolinium-enhanced fat suppressed SGE demonstrated variations of mural enhancement that correlated well with extent of disease severity in 10/11 patients. Complications such as intraperitoneal (i. p.) abscess (2 patients), gastric outlet obstruction (1 patient), bowel obstruction (2 patients), and fistula formation (3 patient), were accurately shown. We conclude that T(2)-weighted half-Fourier RARE and gadolinium-enhanced fat suppressed SGE sequences are complementary techniques that possess different imaging features that are of value for assessing bowel changes in Crohn's disease.