Magnetic resonance imaging of the small bowel

(a) (Coronal fat saturated follow through) showing normal findings. (b) (Axial T2 fat saturated follow through) showing normal findings.

(Post-gadolinium, fat saturated coronal) showing normal bowel wall thickness (with up to 3mm of luminal distension).

(a) (Coronal T2 FIESTA) showing skip lesions which are concentric, symmetrical or asymmetrical (pseudo sacculation). (b) showing inflammatory mesenteric stranding within the distal ileum (yellow arrow). (c) (Post-Gadolinium) showing wall thickening (yellow arrow), stratified enhancement, ‘Comb sign’ –mesenteric hyperaemia (red arrow) and lymph nodes (green arrow). (d) (Axial T2 FIESTA) showing concentric, asymmetrical bowel wall thickening.

(a) (Coronal FIESTA) showing large featureless dilated small bowel in the proximal jejunum which narrows inferiorly to a strictured segment. There is fat hypertrophy of the adjacent mesentery, which is typical of Crohn’s. (b) (post-Gad) showing contrast enhancement of the inflammatory stricture.

(a) (Coronal FIESTA) and (b) (axial FIESTA) showing circumferential thickening of the proximal Jejunum due to adenocarcinoma. (c) showing intense contrast enhancement of the tumour.

(Axial T1WI) showing the creeping fat hypertrophy associated with chronic Crohn’s disease.