Ultrasound and magnetic resonance imaging in Crohn's disease: a comparison

The objective of this retrospective study was to compare MRI of the abdomen with ultrasound of the abdomen and gastrointestinal tract in patients with Crohn's disease. Forty-six patients were included in the study. We analyzed the localization of Crohn's lesions, the number of affected bowel segments, the number of stenoses, and the presence of abscesses, fistulae, and any additional findings. Findings were verified by means of one or more of the following: enteroclysis; surgical findings; and colonoscopy. The results show that MRI is superior to ultrasound in the localization of affected bowel segments (sensitivity: MRI 97.5%; US 76%) and in recognizing fistulae (sensitivity: MRI 87%; US 31%), stenoses (sensitivity: MRI 100%; US 58%) and abscesses (sensitivity: MRI 100%; US 89%). Magnetic resonance imaging of the abdomen should be obtained to clarify discrepant clinical and sonographic findings. In addition, despite its higher cost, MRI of the abdomen is justified in patients in whom Crohn's lesions are known or suspected in anatomic areas proximal to the terminal or neoterminal ileum and in cases with suspicion of fistulae and abscesses.