The Role of Magnetic Resonance Enterography (MRE) in Management of Crohn’s Disease

Abstract

Background: The Crohn’s disease is a chronic inflammatory bowel disease with increasing incidence in Iraq and Kurdistan region in last decade. The imaging modalities have great advantages in diagnosis and follow up of the disease.           

Objective: To assess the epidemiology, clinical manifestations and treatment characteristics of patients with Crohn’s disease and evaluating the role magnetic resonance enterography in management of Crohn’s.

Patients and Method: This study was an observational cross sectional study implemented in Kurdistan center for Gastroenterology and Hepatology (KCGH) in Sulaimani city and Hawler Gasteroenterology and hepatology Center (HGHC) Erbil city-Kurdistan region/Iraq during the period of eight months from 1st of January to 31st of August, 2022 convenient sample of fifty patients with Crohn’s disease. The specialist responsible decided to do magnetic resonance enterography, depending on clinical status of the patients, laboratory results and lack of response to treatments.

Results: The final decision regarding Crohn’s disease treatment was newly started (14%), or no change (26%) or change; biological (48%), surgery (8%), biological, surgery and percutaneous drainage (2%) and biological and surgery (2%). Common magnetic resonance enterography findings were small bowel thickening, wall enhancement, Comb sign and lymph node enlargement. There was a significant association between magnetic resonance enterography findings and treatment decision (p=0.003). Other factors related to treatment decision in CD are disease duration, Harvey-Bradshow index of severity, fecal calprotectin test and C-reactive protein test.

Conclusions: The magnetic resonance enterography has a major role in evaluation of Crohn’s disease management