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Crohn Disease
Atif Zaheer, MD, FSAR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Terminal ileitis, regional enteritis, ileocolitis
              • Definitions

                • Disease of unknown etiology characterized by transmural inflammation of GI tract

              IMAGING

              • General Features

                • Fluoroscopic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Other Modality Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Staging, Grading, & Classification

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Consider

                                                • Image Interpretation Pearls

                                                  Selected References

                                                  1. Guglielmo FF et al: Small bowel crohn disease at CT and MR enterography: imaging atlas and glossary of terms. Radiographics. 40(2):354-75, 2020
                                                  2. Bruining DH et al: Consensus recommendations for evaluation, interpretation, and utilization of computed tomography and magnetic resonance enterography in patients with small bowel Crohn's disease. Radiology. 286(3):776-99, 2018
                                                  3. Gajendran M et al: A comprehensive review and update on Crohn's disease. Dis Mon. 64(2):20-57, 2018
                                                  4. Gomollón F et al: 3rd European evidence-based consensus on the diagnosis and management of crohn's disease 2016: part 1: diagnosis and medical management. J Crohns Colitis. 11(1):3-25, 2017
                                                  5. Allen BC et al: MR enterography for assessment and management of small bowel Crohn disease. Radiol Clin North Am. 52(4):799-810, 2014
                                                  6. Mandel MD et al: Have biologics changed the natural history of Crohn's disease? Dig Dis. 32(4):351-9, 2014
                                                  7. Marineaţă A et al: Extra intestinal manifestations and complications in inflammatory bowel disease. Rev Med Chir Soc Med Nat Iasi. 118(2):279-88, 2014
                                                  8. Qiu Y et al: Systematic review with meta-analysis: magnetic resonance enterography vs. computed tomography enterography for evaluating disease activity in small bowel Crohn's disease. Aliment Pharmacol Ther. 40(2):134-46, 2014
                                                  9. Rodriguez P et al: Imaging Crohn disease: MR enterography. J Comput Assist Tomogr. 38(2):219-27, 2014
                                                  10. Yassin NA et al: Systematic review: the combined surgical and medical treatment of fistulising perianal Crohn's disease. Aliment Pharmacol Ther. 40(7):741-9, 2014
                                                  11. Baker ME et al: Mural attenuation in normal small bowel and active inflammatory Crohn's disease on CT enterography: location, absolute attenuation, relative attenuation, and the effect of wall thickness. AJR Am J Roentgenol. 192(2):417-23, 2009
                                                  12. Lee SS et al: Crohn disease of the small bowel: comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. Radiology. 251(3):751-61, 2009
                                                  13. Amitai MM et al: Multislice CT compared to small bowel follow-through in the evaluation of patients with Crohn disease. Clin Imaging. 32(5):355-61, 2008
                                                  14. Bruining DH et al: Prevalence of penetrating disease and extraintestinal manifestations of Crohn's disease detected with CT enterography. Inflamm Bowel Dis. 14(12):1701-6, 2008
                                                  15. Hara AK et al: Using CT enterography to monitor Crohn's disease activity: a preliminary study. AJR Am J Roentgenol. 190(6):1512-6, 2008
                                                  16. Solem CA et al: Small-bowel imaging in Crohn's disease: a prospective, blinded, 4-way comparison trial. Gastrointest Endosc. 68(2):255-66, 2008
                                                  17. Bodily KD et al: Crohn Disease: mural attenuation and thickness at contrast-enhanced CT enterography--correlation with endoscopic and histologic findings of inflammation. Radiology. 238(2):505-16, 2006
                                                  18. Wold PB et al: Assessment of small bowel Crohn disease: noninvasive peroral CT enterography compared with other imaging methods and endoscopy--feasibility study. Radiology. 229(1):275-81, 2003
                                                  19. Low RN et al: Crohn disease with endoscopic correlation: single-shot fast spin-echo and gadolinium-enhanced fat-suppressed spoiled gradient-echo MR imaging. Radiology. 222(3):652-60, 2002
                                                  20. Antes G: [Inflammatory bowel diseases. Colon contrast enema and CT] Radiologe. 38(1):41-9, 1998
                                                  21. Gore RM et al: CT features of ulcerative colitis and Crohn's disease. AJR Am J Roentgenol. 167(1):3-15, 1996
                                                  22. Hizawa K et al: Crohn disease: early recognition and progress of aphthous lesions. Radiology. 190(2):451-4, 1994
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            • Diagnostic Checklist

                                                              TERMINOLOGY

                                                              • Synonyms

                                                                • Terminal ileitis, regional enteritis, ileocolitis
                                                              • Definitions

                                                                • Disease of unknown etiology characterized by transmural inflammation of GI tract

                                                              IMAGING

                                                              • General Features

                                                                • Fluoroscopic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Ultrasonographic Findings

                                                                        • Other Modality Findings

                                                                          • Imaging Recommendations

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                • Staging, Grading, & Classification

                                                                                  • Gross Pathologic & Surgical Features

                                                                                    • Microscopic Features

                                                                                      CLINICAL ISSUES

                                                                                      • Presentation

                                                                                        • Demographics

                                                                                          • Natural History & Prognosis

                                                                                            • Treatment

                                                                                              DIAGNOSTIC CHECKLIST

                                                                                              • Consider

                                                                                                • Image Interpretation Pearls

                                                                                                  Selected References

                                                                                                  1. Guglielmo FF et al: Small bowel crohn disease at CT and MR enterography: imaging atlas and glossary of terms. Radiographics. 40(2):354-75, 2020
                                                                                                  2. Bruining DH et al: Consensus recommendations for evaluation, interpretation, and utilization of computed tomography and magnetic resonance enterography in patients with small bowel Crohn's disease. Radiology. 286(3):776-99, 2018
                                                                                                  3. Gajendran M et al: A comprehensive review and update on Crohn's disease. Dis Mon. 64(2):20-57, 2018
                                                                                                  4. Gomollón F et al: 3rd European evidence-based consensus on the diagnosis and management of crohn's disease 2016: part 1: diagnosis and medical management. J Crohns Colitis. 11(1):3-25, 2017
                                                                                                  5. Allen BC et al: MR enterography for assessment and management of small bowel Crohn disease. Radiol Clin North Am. 52(4):799-810, 2014
                                                                                                  6. Mandel MD et al: Have biologics changed the natural history of Crohn's disease? Dig Dis. 32(4):351-9, 2014
                                                                                                  7. Marineaţă A et al: Extra intestinal manifestations and complications in inflammatory bowel disease. Rev Med Chir Soc Med Nat Iasi. 118(2):279-88, 2014
                                                                                                  8. Qiu Y et al: Systematic review with meta-analysis: magnetic resonance enterography vs. computed tomography enterography for evaluating disease activity in small bowel Crohn's disease. Aliment Pharmacol Ther. 40(2):134-46, 2014
                                                                                                  9. Rodriguez P et al: Imaging Crohn disease: MR enterography. J Comput Assist Tomogr. 38(2):219-27, 2014
                                                                                                  10. Yassin NA et al: Systematic review: the combined surgical and medical treatment of fistulising perianal Crohn's disease. Aliment Pharmacol Ther. 40(7):741-9, 2014
                                                                                                  11. Baker ME et al: Mural attenuation in normal small bowel and active inflammatory Crohn's disease on CT enterography: location, absolute attenuation, relative attenuation, and the effect of wall thickness. AJR Am J Roentgenol. 192(2):417-23, 2009
                                                                                                  12. Lee SS et al: Crohn disease of the small bowel: comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. Radiology. 251(3):751-61, 2009
                                                                                                  13. Amitai MM et al: Multislice CT compared to small bowel follow-through in the evaluation of patients with Crohn disease. Clin Imaging. 32(5):355-61, 2008
                                                                                                  14. Bruining DH et al: Prevalence of penetrating disease and extraintestinal manifestations of Crohn's disease detected with CT enterography. Inflamm Bowel Dis. 14(12):1701-6, 2008
                                                                                                  15. Hara AK et al: Using CT enterography to monitor Crohn's disease activity: a preliminary study. AJR Am J Roentgenol. 190(6):1512-6, 2008
                                                                                                  16. Solem CA et al: Small-bowel imaging in Crohn's disease: a prospective, blinded, 4-way comparison trial. Gastrointest Endosc. 68(2):255-66, 2008
                                                                                                  17. Bodily KD et al: Crohn Disease: mural attenuation and thickness at contrast-enhanced CT enterography--correlation with endoscopic and histologic findings of inflammation. Radiology. 238(2):505-16, 2006
                                                                                                  18. Wold PB et al: Assessment of small bowel Crohn disease: noninvasive peroral CT enterography compared with other imaging methods and endoscopy--feasibility study. Radiology. 229(1):275-81, 2003
                                                                                                  19. Low RN et al: Crohn disease with endoscopic correlation: single-shot fast spin-echo and gadolinium-enhanced fat-suppressed spoiled gradient-echo MR imaging. Radiology. 222(3):652-60, 2002
                                                                                                  20. Antes G: [Inflammatory bowel diseases. Colon contrast enema and CT] Radiologe. 38(1):41-9, 1998
                                                                                                  21. Gore RM et al: CT features of ulcerative colitis and Crohn's disease. AJR Am J Roentgenol. 167(1):3-15, 1996
                                                                                                  22. Hizawa K et al: Crohn disease: early recognition and progress of aphthous lesions. Radiology. 190(2):451-4, 1994