A-438 16:30 B. Small bowel and colon: how to study a patient with suspected inflammatory bowel disease N. Papanikolaou; Iraklion/GR (nickolas.papanikolaou@gmail.com) MR Enteroclysis and MR Colonography examinations have been mainly utilised to study patients with Crohn's disease. Early, subtle lesions such as superficial ulceration, mucosal nodularity and thickening or distortion of the intestinal folds may be detected by MRE, although to a lesser extent comparing with conventional enteroclysis, due to its lower spatial resolution. To improve detection rate of these subtle lesions utilisation of dedicated ultrafast, high-resolution pulse sequences, coupled with strong gradients have to be considered. Fibrofatty proliferation can be easily depicted, while its composition regulates its signal intensity characteristics being of low signal intensity in case of fibrosis and of high signal intensity in case of excessive fat accumulation. Gadolinium uptake on FLASH images allows identification of hyperemic bowel segments due to inflammation and accompanying small inflammatory nodes. Certain MR imaging findings, including the presence of deep ulcers, wall thickness more than 7 mm and marked mesenteric lymph nodes gadolinium enhancement were well correlated with the clinical activity index (CDAI), and it is suggested that such findings may serve as indicators of Crohn's disease activity. Another important clinical challenge that MR Enteroclysis and MR Colonography must address is accurate disease subtype classification. By recruiting multiple contrast mechanisms like signal intensity on T2-weighted images, contrastenhancement patterns on T1-weighted post gadolinium gradient echo images and motility-related information as identified on cine-TrueFISP images the latter clinical questions can be answered in a certain extent. Learning Objectives: