Research papersMR Enterography in Crohn's disease complicated with enteroenteric fistula

•The classic “star- sign” is present in 26.3% of enteroenteric fistulas.•Perienteric mesenteric inflammation and fluid collection are common in enteroenteric fistulization.•In Crohn'disease, a correlation exists between MaRIA index and CRP values.•The presence of perianal disease is independent of intestinal penetrating disease.•Surgical treatment of enteric fistula is highly dependent upon patients' symptoms.

ObjectiveIn this retrospective study, we aimed to evaluate MR enterography (MRE) findings, MR index of activity (MaRIA) and laboratory markers in Crohn patients with enteroenteric fistula.MethodsInstitution's electronic medical records (laboratory, pathology, ileocolonoscopy results and discharge summary) were reviewed and MR images retrieved from the PACS were reanalyzed in Crohn patients assessed at Gastroenterology Clinic of our university between July 2011 and July 2016. MR enterography and clinic parameters of 38 Crohn patients with enteroenteric fistula and 48 Crohn patients without enteroenteric fistula were compared.ResultsOf the findings, perienteric inflammation was seen only in fistula group. The mean wall thickness was significantly greater; perienteric fluid, mural hyperenhancement, cecal contraction, thickening of ileocecal valve, and colonic involvement were significantly more common in fistula patients. There was no significant difference between groups with regards to MaRIA index and perianal disease. In patients with enteroenteric fistula, there was significant association between the presence of hypoalbuminemia and presence of ileitis at ileocolonoscopy. In the overall study population, there was a positive correlation between the MaRIA and CRP values at the time of the MRE.ConclusionsPerienteric mesenteric inflammation and fluid collection are common in enteroenteric fistulization. MaRIA indices and laboratory findings of patients with enteroenteric fistula are not significantly different from those without fistulas.