MR enteroclysis had a clear advantage over conventional enteroclysis in the demonstration of extramural manifestations or complications of Crohn's disease. The extent of fibro-fatty proliferation and its composition, mostly fatty or mostly fibrotic, could be assessed with MR enteroclysis, especially when true FISP images were obtained (Fig. 3). The so-called comb sign (Fig. 4), corresponding to increased mesenteric vascularity, could be ideally seen on true FISP images close to the mesenteric border of a small-bowel segment in the form of short, parallel, low-signal-intensity linear structures perpendicular to the intestinal long axis. The comb sign could be seen on three-dimensional FLASH images as high-signal-intensity linear elements.
Small mesenteric lymph nodes were easily detected by their low signal intensity within the high-signal-intensity mesenteric fat on true FISP images (Fig. 5). Their presence was not as obvious with other MR enteroclysis sequences due to short T2 filtering effects on HASTE images and to saturation of mesen-teric fat signal on three-dimensional FLASH images. Sinus tracts and fistulae were disclosed by the highsignal intensity of their fluid content on true FISP and HASTE images, but they could be missed on the three-dimensional FLASH images due to limited contrast with surrounding tissues. All fistulae shown at conventional enteroclysis were also depicted at MR enteroclysis, while only half of the sinus tracts were detected at MR enteroclysis, even in retrospect in our series. Abscesses could be recognized by their fluid content and contrast enhancement of the wall. There were strong indications that disease activity can be appreciated with MR enteroclysis (Fig. 6) [34, 35].
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