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Colonic strictures in children and young adults with Crohn's disease: Recognition on MR enterography

  • David M. Biko
    Correspondence
    Corresponding author at: Department of Radiology, The Children's Hospital of Philadelphia, 34th and Civic Ctr Blvd, Philadelphia, PA 19104, United States.
    Affiliations
    Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States

    University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
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  • Petar Mamula
    Affiliations
    Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States

    University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
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  • Nancy A. Chauvin
    Affiliations
    Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States

    University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
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  • Sudha A. Anupindi
    Affiliations
    Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States

    University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
    Search for articles by this author

      Highlights

      • Colonic strictures in pediatric Crohn's disease can be evaluated with MRE.
      • Pre-stenotic dilatation and luminal narrowing are MRE criteria for colonic strictures.
      • Strictures on MRE correlated with strictures on colonoscopy in most cases.
      • When comparing with surgical findings, MRE was always concordant.

      Abstract

      Objectives

      Identify MRE features of colonic strictures in children/young adults with Crohn's disease.

      Methods

      Included are patients with colonic strictures on colonoscopy imaged with MRE. Bowel wall thickening (BWT) with luminal narrowing, pre-stenotic dilatation (PSD), bowel wall enhancement, and diffusion restriction were evaluated.

      Results

      All potential strictures (n = 12) had BWT with luminal narrowing on MRE. 8/12 had PSD, meeting our MRE stricture criteria. MRE diagnosed 8/12 colonic strictures compared to colonoscopy but was concordant with findings in all surgical patients.

      Conclusion

      Strictures on MRE did not always agree with colonoscopy, but when correlating with surgery, MRE findings were all concordant.
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