Anastomotic recurrence of Crohn's disease after ileocolic resection: comparison of MR enteroclysis with endoscopy

Eur Radiol. 2008 Nov;18(11):2512-21. doi: 10.1007/s00330-008-1034-6. Epub 2008 May 27.


The purpose of this study was to assess the accuracy of MR enteroclysis in patients with Crohn's disease recurrence after ileocolic resection and to establish an MR scoring sytem. MR enteroclysis and endoscopy were performed in 30 patients with suspected Crohn's disease recurrence after ileocolic resection. Findings were evaluated by three radiologists, using an MR score based on image quality, contrast enhancement, and mural and extramural bowel-wall changes: MR0 (no abnormal features), MR1 (minimal mucosal changes), MR2 (diffuse aphtoid ileitis, moderate recurrence), and MR3 (severe recurrence with trans- and extramural changes). The endoscopic Rutgeerts score defines changes at the ileum on a scale from I0 to I4. In 3/30 (10%) patients, evaluation was not possible. The mean overall image quality was rated as 1.7 (kappa 0.78). Comparing MR and Rutgeerts score, the mean observer agreement for the total score rating was 77.8% (kappa 0.67). When comparing only scores below or above MR2-the threshold indicative of the necessity of medical treatment-there was a total agreement of 95.1% (kappa 0.84). MR enteroclysis allows assessment of Crohn's disease recurrence after ileocolic resection. The MR score is reproducible and shows high agreement with the approved endoscopic Rutgeerts score.

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / adverse effects*
  • Colon / surgery
  • Crohn Disease / diagnosis*
  • Crohn Disease / etiology*
  • Crohn Disease / surgery
  • Endoscopy, Gastrointestinal / methods*
  • Female
  • Humans
  • Ileum / surgery
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Recurrence
  • Treatment Outcome
  • Young Adult