MRI of Perianal Crohn Disease: Technique and Interpretation

Area of Science:

• Gastroenterology
• Radiology
• Surgical Oncology

Background:

• Perianal fistulizing disease, often associated with Crohn disease, requires advanced imaging for effective management.
• Magnetic resonance imaging (MRI) is the preferred modality for evaluating these complex conditions.
• Evolving treatment strategies necessitate precise imaging to guide interventions.

Purpose of the Study:

• To highlight the importance of perianal MRI in managing fistulizing Crohn disease.
• To introduce a standardized reporting template for perianal fistulas.
• To review the postoperative imaging appearance of fistula treatments.

Main Methods:

• Review of current literature on perianal MRI and fistula classification.
• Discussion of normal anatomy and common pathologies.
• Analysis of imaging findings post-treatment.

Main Results:

• Perianal MRI provides essential information for treatment selection, timing, and response assessment.
• A structured reporting template can improve communication and patient care.
• Familiarity with normal anatomy and postoperative changes is key for accurate interpretation.

Conclusions:

• Standardized perianal MRI reporting is vital for optimizing the management of fistulizing Crohn disease.
• The proposed template aids in assessing fistula complexity and treatment efficacy.
• Radiologists play a critical role in guiding therapeutic decisions through accurate MRI interpretation.