Open Access Research article

Magnetic resonance enterography in pregnant women with Crohn’s disease: case series and literature review

Myriam D Stern1, Uri Kopylov2*, Shomron Ben-Horin2, Sarah Apter1 and Marianne Michal Amitai1

Author Affiliations

1 Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel

2 Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel

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BMC Gastroenterology 2014, 14:146  doi:10.1186/1471-230X-14-146

Published: 16 August 2014

Abstract

Background

Evaluation of pregnant women with known or suspected Crohn’s disease (CD) remains a challenge. Magnetic Resonance Enterography (MRE) is a promising diagnostic tool in these patients; however, the clinical data on MRE utilization in pregnancy is scarce. The aim of the study was to describe the experience with MRE in pregnant CD patients in a tertiary referral center.

Methods

We retrospectively reviewed MRE studies performed in pregnant women with known or suspected CD that were performed between January 2007 and November 2012. Imaging findings, clinical management and outcome were extracted from patient’s file and electronic records. Image quality was evaluated.

Results

Ten studies of 9 patients were included. MRE protocol was modified to maximize maternal and fetal safety, and intravenous gadolinium was not used. In 7 patients, CD diagnosis was previously established; six were admitted with clinical symptoms consistent with CD exacerbation, and an additional patient with a recurrent groin abscess without apparent luminal symptoms. In all seven patients, imaging features consistent with active CD were detected; new penetrating complications were detected in 4 patients. Two patients underwent MRE for suspected CD which was not comforted by study results. The clinical management was significantly impacted by MRE results in all positive cases. The image quality of the fast MRE sequences obtained without gadolinium was satisfactory and allowed meaningful interpretation.

Conclusion

MRE with an adapted protocol for pregnancy is a reliable imaging modality to manage in pregnant women with known or suspected CD.

Keywords:
Crohn’s disease; Pregnancy; Magnetic resonance enterography; MRI