Kakkar Chandan, Bonaffini Pietro Andrea, Singh Arshdeep, Narang Vikram, Mahajan Ramit, Verma Shruti, Singla Saurabh, Sood Ajit
Dayanand Medical College & Hospital, Ludhiana, India.
University of Milano-Bicocca, Milan, Italy.
Abdom Radiol (NY). 2025 Feb 3. doi: 10.1007/s00261-025-04824-z.
Magnetic resonance enterography (MRE) has become an essential imaging modality for evaluating small bowel disorders, particularly Crohn's disease (CD), due to its superior soft-tissue contrast, multiplanar capabilities, and lack of ionizing radiation. While radiologists are generally familiar with the MRE findings of CD, several other small bowel entities can present with similar imaging features, potentially leading to diagnostic challenges. This pictorial review comprehensively illustrates the MRE findings of CD and its various mimickers, including Ulcerative colitis (UC), intestinal tuberculosis (ITB), Non-steroidal anti-inflammatory drug (NSAID) induced enteropathy, cryptogenic multifocal ulcerating and stenosing enteropathy (CMUSE), celiac disease, gastrointestinal endometriosis, intestinal lipomatosis, lymphangiectasia, eosinophilic enteritis, encapsulating peritoneal sclerosis, adhesions, radiation enteropathy, and intestinal angioedema etc. We discuss the key imaging features that can help a radiologist differentiate these conditions, highlight specific MRE sequences useful for diagnosis, and provide clinically relevant context for each entity. This review serves as a practical guide for radiologists and clinicians in recognizing and distinguishing various small bowel pathologies that may simulate CD on MRE, ultimately aiding in appropriate patient management.
磁共振小肠造影(MRE)因其卓越的软组织对比度、多平面成像能力以及无电离辐射,已成为评估小肠疾病,尤其是克罗恩病(CD)的重要成像方式。虽然放射科医生通常熟悉CD的MRE表现,但其他几种小肠疾病也可能呈现出相似的影像特征,这可能导致诊断上的挑战。本图片综述全面展示了CD及其各种模仿疾病的MRE表现,包括溃疡性结肠炎(UC)、肠结核(ITB)、非甾体抗炎药(NSAID)所致小肠病、隐源性多灶性溃疡性狭窄性小肠病(CMUSE)、乳糜泻、胃肠道子宫内膜异位症、肠道脂肪瘤、淋巴管扩张症、嗜酸性肠炎、包裹性腹膜硬化症、粘连、放射性小肠病以及肠道血管性水肿等。我们讨论了有助于放射科医生鉴别这些疾病的关键影像特征,强调了对诊断有用的特定MRE序列,并为每种疾病提供了临床相关背景。本综述为放射科医生和临床医生识别和区分在MRE上可能模拟CD的各种小肠病变提供了实用指南,最终有助于对患者进行恰当的管理。