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Related Experiment Video

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Crohn Disease Strictures: Multimodality Imaging to Identify Imaging Biomarkers.

Safa Hoodeshenas1, Jonathan R Dillman1, Stuart A Taylor1

  • 1From the Department of Radiology (S.H., K.A.R., A.L., D.J.B., A.H.G., S.C., J.G.F.), Division of Gastroenterology and Hepatology (D.H.B.), and Department of Laboratory Medicine and Pathology (C.E.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Center for Medical Imaging, University College London, London, UK (S.A.T.); IBD Unit, Department of Radiology, Hospital Clínic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain (J.R.); Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (B.T.); Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio (F.R.); Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute and Program for Global Translational Inflammatory Bowel Disease Research, Cleveland Clinic, Cleveland, Ohio (F.R.); Alimentiv, London, Ontario, Canada (B.F.); Department of Medicine and Department of Epidemiology and Statistics, University of Western Ontario, London, Ontario, Canada (B.F.); and Imaging Institute, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio (M.E.B.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|October 16, 2025
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Summary

Imaging biomarkers for Crohn disease (CD) small bowel strictures aid in diagnosis and surgical risk assessment. New quantitative biomarkers show promise for assessing fibrosis and inflammation, guiding patient management.

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Area of Science:

  • Gastroenterology
  • Radiology
  • Medical Imaging

Background:

  • Crohn disease (CD) small bowel strictures cause complications requiring surgery.
  • Standardized imaging features for CD strictures are established.
  • Accurate assessment of stricture characteristics is crucial for management.

Purpose of the Study:

  • To review and define morphologic imaging features of small bowel strictures in CD.
  • To highlight the role of imaging biomarkers in diagnosing and measuring strictures.
  • To discuss emerging quantitative biomarkers for histopathologic correlates and biomechanical properties.

Main Methods:

  • Review of routine MR and CT enterography features.
  • Focus on quantitative imaging biomarkers, particularly MRI and US methods.
  • Analysis of biomarkers reflecting fibrosis, inflammation, and smooth muscle hyperplasia/hypertrophy.

Main Results:

  • Morphologic imaging features of CD small bowel strictures are defined.
  • Imaging biomarkers can reproducibly diagnose and measure strictures.
  • Emerging biomarkers show potential for assessing histopathologic and biomechanical properties.

Conclusions:

  • Imaging is essential for managing patients with stricturing CD.
  • Incorporating defined imaging features into reports can guide management and clinical trials.
  • Quantitative imaging biomarkers offer promising avenues for precise assessment of stricture composition and properties.