title: Magnetic resonance enterography in pregnant women with Crohn's disease: case series and literature review.
abstract: BACKGROUND
  Evaluation of pregnant women with known or suspected Crohn's disease (CD) remains a challenge. Magnetic Resonance Enterography (MRE) is a promising diagnostic tool in these patients; however, the clinical data on MRE utilization in pregnancy is scarce. The aim of the study was to describe the experience with MRE in pregnant CD patients in a tertiary referral center.
  
  
  METHODS
  We retrospectively reviewed MRE studies performed in pregnant women with known or suspected CD that were performed between January 2007 and November 2012. Imaging findings, clinical management and outcome were extracted from patient's file and electronic records. Image quality was evaluated.
  
  
  RESULTS
  Ten studies of 9 patients were included. MRE protocol was modified to maximize maternal and fetal safety, and intravenous gadolinium was not used. In 7 patients, CD diagnosis was previously established; six were admitted with clinical symptoms consistent with CD exacerbation, and an additional patient with a recurrent groin abscess without apparent luminal symptoms. In all seven patients, imaging features consistent with active CD were detected; new penetrating complications were detected in 4 patients. Two patients underwent MRE for suspected CD which was not comforted by study results. The clinical management was significantly impacted by MRE results in all positive cases. The image quality of the fast MRE sequences obtained without gadolinium was satisfactory and allowed meaningful interpretation.
  
  
  CONCLUSIONS
  MRE with an adapted protocol for pregnancy is a reliable imaging modality to manage in pregnant women with known or suspected CD.
authors.forename: Myriam D
authors.initials: MD
authors.lastname: Stern
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel. ukopylov@gmail.com.
authors.forename: Uri
authors.initials: U
authors.lastname: Kopylov
authors.forename: Shomron
authors.initials: S
authors.lastname: Ben-Horin
authors.forename: Sarah
authors.initials: S
authors.lastname: Apter
authors.forename: Marianne Michal
authors.initials: MM
authors.lastname: Amitai
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies