Magnetic resonance enterography guiding treatment in children with Crohn's jejunoileitis

Aim: To determine the usefulness of magnetic resonance enterography (MRE) in treatment for paediatric patients with Crohns disease. Methods: To evaluate small bowel involvement, 45 children with Crohns disease were scheduled for MRE. Two radiologists blinded to the patient data independently re-evaluated the images. Findings in images were compared to macroscopic findings at surgery or endoscopy. Results: The terminal ileum was visualized in all with a completed procedure (43/45). The treatment remained conservative in 74% after imaging. In all 13 patients who underwent ileocolonoscopy within 3 months of MRE, the MRE findings were comparable with the macroscopic findings or revealed a more extensive disease. Bowel resection was performed in 26% after imaging. The macroscopic findings in the bowel corresponded to the MRE findings in 73%. In three MRE suggested a more severe disease than was verified intraoperatively. Conclusions: Magnetic resonance enterography identifies disease involvement in the small bowel in young patients with Crohns disease and may guide decisions on the need for intestinal surgery or adjustment of medication.