MR Enterography

Contrast-enhanced MRI of the small bowel for Crohn's disease assessment, small bowel tumours, and obscure GI bleeding. Includes oral contrast preparation and IV gadolinium.

MR enterography (MRE) is a specialised examination designed to image the small bowel — particularly the ileum and jejunum — which is difficult to assess by conventional endoscopy. The patient drinks an oral contrast agent (typically a polyethylene glycol or mannitol solution) approximately 45-60 minutes before the scan to distend the small bowel loops and provide intraluminal contrast. Intravenous gadolinium is then administered during the scan to evaluate bowel wall enhancement, which indicates active inflammation. The examination is the gold standard for assessing Crohn's disease activity and complications — strictures, fistulae, abscesses, and skip lesions — and for monitoring response to treatment. It provides simultaneous assessment of both the bowel wall (thickness, enhancement pattern, oedema) and extraluminal structures (mesenteric fat stranding, lymphadenopathy, vascular engorgement of the vasa recta — the 'comb sign'). At 12,500 CZK, the price includes the IV gadolinium contrast. The oral bowel preparation is typically provided by the facility. MR enterography has largely replaced small bowel barium follow-through for Crohn's assessment, offering superior soft-tissue contrast and no radiation exposure — an important consideration for the typically young patient population with Crohn's disease who require repeated imaging over their lifetime.