Crohn’s Disease

What is Crohn’s Disease?

Crohn’s Disease is a chronic condition that causes recurrent episodes of inflammation involving the lining of the intestinal tract. Although the exact cause of Crohn’s disease is unknown, it has been linked to race, family history, smoking and an abnormal immune response to intestinal bacteria. Symptoms include: abdominal pain, cramping, severe diarrhea, bloody stools, weight loss and malnutrition.

Are there Complications?

Chronic intestinal inflammation can lead to:
• Areas of intestinal narrowing called strictures, which can cause intestinal blockage.
• Pockets of infection/pus, called abscesses.
• Abnormal communications between the intestine and other structures in the body, called fistulas.

How is Crohn’s Disease Diagnosed?

First, all other possible causes for the symptoms should be ruled out. Radiology imaging, such as CT and MRI, are used to help make the diagnosis. A CT (Computed Tomography) uses radiation-producing x-rays to take detailed pictures of all the structures inside the body. MRI (Magnetic Resonance Imaging) does the same thing, but uses magnets and radio waves, instead of radiation.

Why are CT or MRI enterography important?

Cutting-edge radiology imaging, such as CT or MRI enterography, has become
increasingly important in the diagnosis and monitoring of the disease. Enterography is when the patient drinks non-harmful liquid contrast prior to the procedure. This contrast highlights the intestines, improving detail. Both CT and MRI are superior for locating areas of intestinal involvement and evaluation of associated complications. Triad Radiology Associates is proud to have several radiologist that specialize in this particular type of imaging.

Are there advantages of MRI over CT?

The first and most important advantage of MRI is the lack of radiation exposure (unlike CT). Crohn’s disease has an unpredictable lifelong course that includes frequent relapses. Since it often affects young patients, who are most vulnerable to the potential adverse effects of repeated radiation exposure, MRI is better suited for repeated imaging for disease monitoring and surgical planning.

A second advantage of MRI is the ability to take multiple pictures over time and link them together to make a short movie or “cine.” This shows intestinal movement and helps find areas that look or move abnormally, thereby helping doctors identify areas that should be monitored or even removed, to avoid further complications.

The third advantage of MRI is its superior ability to produce images that are very sensitive to the smallest amount of “active,” or ongoing inflammation. This leads to earlier detection and therefore earlier treatment.

What should I expect during a MRI?

Since MRI involves large magnets, you will be asked to remove all metal from the body. In addition to drinking liquid contrast, contrast may also be injected into the vein during the exam, through an IV placed by the technologist prior to starting. For people who experience claustrophobia, anti-anxiety medication can be arranged by a physician. You will be placed on a table that slides into the magnet, which is shaped like a large cylinder. Each set of images takes a few minutes to acquire and the entire exam takes anywhere from 10 to 25 minutes. After the exam is over, the IV will be removed. The images are transferred to a computer for the Radiologist (radiology doctor) to review, and a detailed report is sent to your physician.

By Leslie Fort, MD, Staff Radiologist, Triad Radiology Associates