Abstract
ObjectivesTo provide an overview of less well-known small bowel and mesenteric diseases found at small bowel magnetic resonance (MR) enterography/enteroclysis and to review the imaging findings. MR enterography and enteroclysis are important techniques for evaluation of small bowel diseases. In most centres these techniques are primarily used in Crohn’s disease, and most radiologists are familiar with these MRI findings. However, the knowledge of findings in other diseases is often sparse, including diseases that may cause similar clinical symptoms to those of Crohn’s disease.MethodsWe present a spectrum of less common and less well-known bowel and mesenteric diseases (e.g. internal hernia, intussusception, neuroendocrine tumour) from our small bowel MR database of over 2,000 cases.ResultsThese diseases can be found in patients referred for bowel obstruction, abdominal pain or rectal blood loss. Further, in patients with (or suspected to have) Crohn’s disease, some of these diseases (e.g. neuroendocrine tumour, familial Mediterranean fever) may mislead radiologists to erroneously diagnose active Crohn’s disease.ConclusionRadiologists should be familiar with diseases affecting the small bowel other than Crohn’s disease, including diseases that may mimic Crohn’s disease.
Highlights
Magnetic resonance (MR) enterography and enteroclysis are important techniques for small bowel evaluation, combining good soft tissue contrast, detection of extraenteric findings, lack of radiation exposure and repeated data acquisition for functional bowel evaluation [1]
Radiologists should be familiar with less well-known diseases affecting the small bowel other than Crohn’s disease as these diseases may be detected in patients referred for small bowel MR enterography or enteroclysis
Peritonitis of small bowel loops may occur in common diseases causing acute abdominal pain, in post-surgical patients and in rarer diseases such as familial Mediterranean fever
Summary
Magnetic resonance (MR) enterography and enteroclysis are important techniques for small bowel evaluation, combining good soft tissue contrast, detection of extraenteric findings, lack of radiation exposure and repeated data acquisition for functional bowel evaluation [1]. It is preferable to use a non-invasive technique without radiation exposure (i.e. ultrasound or MR imaging) to detect small bowel lesions in patients with Crohn’s disease. T1weighted sequences (VIBE) with intravenous contrast medium administration are performed to assess whether enhancing areas (with more perfusion) are present in the small bowel.
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