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Case Discussion;Axial arterial phase; Axial arterial phase; Axial venous phase; Coronal arterial phase; Sagittal venous phase;Crohn disease; An inflammatory disease of the gastrointestinal tract that typically has an indolent course
Characterized by intestinal ulceration, strictures, and fistula formation
Commonly affects young adults, small bowel, particularly the terminal ileum
Small bowel involvement in Crohn disease is typically transmural, with skip lesions
CT and MRI ; CT and MRI
Useful for differentiating between active and fibrotic bowel strictures
Allowing visualization of the entire thickness of the bowel wall
Depicting extraenteric involvement
Providing more detailed and comprehensive information about the extent and severity; Comb sign
Fat halo sign
Bowel wall enhancement
Bowel wall thickness
Stricture and fistula
Mesenteric/intra-abdominal abscess (15%-20%) or phlegmon formation
Ulcerations and loss of haustration
Creeping fat
; Comb sign
Prominence of the vasa recta adjacent to the inflamed loop of bowel
Transmural extension of inflammation across the serosa and to engorgement of the hyperemic vasa recta surrounding the inflamed bowel segment
Not pathognomic of Crohn disease
; Fat halo sign
Infiltration of the submucosa with fat, between the muscularis and the mucosa
Confused with the fat ring sign of mesenteric panniculitis
Nearly pathognomonic of inflammatory bowel disease (Crohn disease and ulcerative colitis)
; Bowel wall enhancement
The result of increased vascular permeability and angiogenesis
The most sensitive indicator of active Crohn disease
Enhancement can be graded by comparing to the precontrast images
Minor increased enhancement
Moderate enhancement
Marked enhancement
No abnormal enhancement: equivalent to normal bowel wall
;Homogeneous; Bowel wall thickness
Normal bowel wall thickness: lumen distended, 1-2 mm; lumen collapsed, 3-4 mm
Mild: 3-5 mm
Moderate:
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