One comparison study between these two modalities demonstrated statistically better detection of superficial mucosal abnormalities over MR enterography but no difference for stenoses and fistulas [50]. In this specific variant, MR enteroclysis theoretically holds the same advantages as outlined for MR enterography because the difference between the two is related to active distention via the nasoduodenal tube at MR enteroclysis versus distention from oral ingestion at MR enterography. Thus, the ability to evaluate mucosal healing as well as assessment of strictures for active disease versus fibrosis as documented at MR enterography should be equivalent at MR enteroclysis [48]. However, the invasive nature with nasoduodenal tube insertion and active infusion of contrast may make it less favorable from a patient perspective, unless a mild stricture without proximal dilation is the clinical question and active distention is needed to confirm this stricture [9]. MR Enterography MR enterography combines contrast-enhanced MRI scanning using fast imaging techniques with an enterography protocol to optimize bowel distension [38]. Similar to the case of CT enterography, this bowel optimization Crohn Disease technique requires the patient to ingest a large volume of oral contrast in a set time period. Additionally, the use of glucagon or prone imaging may help to decrease bowel peristalsis and thus artifact. MR enterography represents an ideal modality for repeated use to monitor therapy given its excellent test characteristics. Given the relatively well status of the patient, they are often able to hold still, and quality examinations are more likely to be consistently obtained. The performance of MR enterography for CD is very good. Rates of sensitivity and specificity are 77% to 82% and 80% to 100%, respectively [24,66,67]; MR enterography can accurately display bowel-wall changes in CD [51-54].
Crohn Disease. One comparison study between these two modalities demonstrated statistically better detection of superficial mucosal abnormalities over MR enterography but no difference for stenoses and fistulas [50]. In this specific variant, MR enteroclysis theoretically holds the same advantages as outlined for MR enterography because the difference between the two is related to active distention via the nasoduodenal tube at MR enteroclysis versus distention from oral ingestion at MR enterography. Thus, the ability to evaluate mucosal healing as well as assessment of strictures for active disease versus fibrosis as documented at MR enterography should be equivalent at MR enteroclysis [48]. However, the invasive nature with nasoduodenal tube insertion and active infusion of contrast may make it less favorable from a patient perspective, unless a mild stricture without proximal dilation is the clinical question and active distention is needed to confirm this stricture [9]. MR Enterography MR enterography combines contrast-enhanced MRI scanning using fast imaging techniques with an enterography protocol to optimize bowel distension [38]. Similar to the case of CT enterography, this bowel optimization Crohn Disease technique requires the patient to ingest a large volume of oral contrast in a set time period. Additionally, the use of glucagon or prone imaging may help to decrease bowel peristalsis and thus artifact. MR enterography represents an ideal modality for repeated use to monitor therapy given its excellent test characteristics. Given the relatively well status of the patient, they are often able to hold still, and quality examinations are more likely to be consistently obtained. The performance of MR enterography for CD is very good. Rates of sensitivity and specificity are 77% to 82% and 80% to 100%, respectively [24,66,67]; MR enterography can accurately display bowel-wall changes in CD [51-54].