Gastrointestinal imaging-practical magnetic resonance imaging approach

Figure 7 Acute on chronic Crohn’s disease. A: Coronal and (B) axial T2-weighted single shot fast spin echo (SSFSE) as well as (C) coronal fat-suppressed T2-weighted SSFSE and (D) coronal fat-suppressed interstitial post-gadolinium 3D-GRE T1-weighted images during the interstitial phase. There is distal small bowel segment which demonstrates diffuse thickening and luminal narrowing (arrows, A), associated with submucosal high signal intensity on T2-weighted images (A and B) and with low-signal intensity on the fat-suppressed T2-weighted images (C), related to submucosal fat deposition, in keeping with chronic Crohn’s disease. There is also a superimposed increased mucosal enhancement in affected bowel segments (arrows, D) and comb sign post-gadolinium images (D), reflecting disease activity, in keeping with acute on top of chronic disease. GRE: Gradient recalled echo.