Related Experiment Video
Updated: Jul 23, 2026
Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
Performance of Surveillance MR Enterography (MRE) in Asymptomatic Children and Adolescents With Crohn's Disease
Katrina F Chu1, Christopher J Moran2, Kaiming Wu1
1Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Background:
MR enterography (MRE) is the primary modality for evaluating small bowel disease in pediatric Crohn's patients. Standard clinical practice includes imaging patients at diagnosis and during symptomatic recurrence. The role for MRE in surveillance of asymptomatic Crohn's patients has not yet been established.
Purpose:
To determine whether MRE imaging features are associated with clinical recurrence.
Study Type:
Retrospective.
Populations:
Pediatric Crohn's patients who underwent MRE while asymptomatic, defined by pediatric gastroenterologists using a physician global assessment; 35 MREs were identified.
Field Strength/Sequence:
1.5T including T2 -weighted single-shot fast spin echo, balanced steady-state free precession, diffusion-weighted, and contrast-enhanced multiphase T1 -weighted gradient recalled echo sequences.
Assessment:
MREs were reviewed by three radiologists independently for mural thickening, T2 -weighted hyperintensity, diffusion restriction, hyperenhancement, vasa recta engorgement, and overall assessment of disease activity. Two pediatric gastroenterologists reviewed patient medical records for 6 months following MRE to evaluate for recurrence, defined as Crohn's-related treatment escalation, surgery, or hospitalization.
Statistical Tests:
Fisher's exact test, Wald chi-square test, and model selection by Akaike information criterion minimization were used to assess statistical significance of MRE imaging features.
Results:
Of 35 MREs identified, seven cases demonstrated clinical recurrence at 6 months (20%); 28 cases remained in remission (80%). Imaging features of active disease were present in 86% of patients with recurrence compared to 29% of patients in remission (P = 0.01). Wall thickening, T2 -weighted hyperintensity, hyperenhancement, and diffusion restriction were significantly associated with recurrence. Multivariate regression analysis determined diffusion restriction to be the best predictor of recurrence within 6 months (P = 0.001, area under the curve 0.786).
Data Conclusion:
MRE performed on young asymptomatic Crohn's patients can identify patients who have a high probability of developing clinical recurrence in a 6-month period, indicating a potential role for surveillance imaging to assess for subclinical active disease.
Level Of Evidence:
3 Technical Efficacy Stage 5 J. Magn. Reson. Imaging 2019;50:1955-1963.
Insights
Magnetic resonance enterography (MRE) can identify asymptomatic pediatric Crohn's patients at high risk for clinical recurrence within six months. Diffusion restriction on MRE is a key predictor of future disease activity, suggesting a role for surveillance imaging.
Area of Science:
- Radiology
- Pediatric Gastroenterology
- Inflammatory Bowel Disease
Background:
- MR enterography (MRE) is the standard for evaluating pediatric Crohn's disease, typically used at diagnosis and during symptomatic recurrence.
- The utility of MRE for surveillance in asymptomatic pediatric Crohn's patients remains unestablished.
Purpose of the Study:
- To investigate the association between MRE imaging features and clinical recurrence in asymptomatic pediatric Crohn's patients.
Main Methods:
- A retrospective review of 35 MREs from asymptomatic pediatric Crohn's patients was conducted.
- Radiologists assessed MREs for disease activity indicators, while gastroenterologists tracked clinical recurrence for six months post-imaging.
- Statistical analyses, including Fisher's exact test and regression, were used to determine the significance of MRE findings.
Main Results:
- Twenty percent of patients experienced clinical recurrence within six months.
- Active disease features on MRE were significantly more prevalent in patients who recurred (86%) versus those in remission (29%).
- Diffusion restriction emerged as the strongest predictor of recurrence (P = 0.001, AUC = 0.786).
Conclusions:
- MRE in asymptomatic pediatric Crohn's patients can identify those at high risk for short-term clinical recurrence.
- The findings suggest a potential role for MRE surveillance to detect subclinical active disease.
More Related Videos
09:01Non-invasive Assessment of the Efficacy of New Therapeutics for Intestinal Pathologies Using Serial Endoscopic Imaging of Live Mice
Published on: March 10, 2015
05:56Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
Published on: August 29, 2025
Related Concept Videos
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
01:28Endoscopic Procedures III: Video Capsule Endoscopy
01:25Inflammatory Bowel Disease III: Crohn's Disease