Fig. 11

MRI follow-up of worsening perianal inflammatory disease in a 40-year-old with severe, refractory CD. Initial MRI (a-c) shows a small-sized abscess of the anovaginal septum (arrowhead in a) originating from a midline recto-VF (thin arrows) with strong enhancement on FS T1-weighted image after gadolinium CM (c). Two years later, despite positioning of a seton (thick arrow in d), repeated MRI (d-f) shows development of complex perianal disease including widened recto-VF (thin arrows) and formation of abscesses in both levator ani muscles. Note vagina (arrows)