The Evolving Role of Cine MRI in Crohn’s Disease: From Functional Motility Analysis to Precision Management: A Review of the Last 10 Years

Cine (dynamic) MRI is a non-invasive MRI technique that captures moving images and can be valuable in evaluating inflammatory bowel disease (IBD). This sequence shows emerging potential in providing functional data to assess bowel motility patterns, to aid in the differentiation between predominantly inflammatory (showing reduced peristalsis) and fibrotic strictures (rigid, non-motile segments) and detecting functional obstructions in Crohn’s disease (CD). Unlike static MRI, cine MRI enables clinicians to observe peristaltic movements, aiding in disease characterization and treatment monitoring. Its non-invasive nature and lack of ionizing radiation make it especially useful for repeated assessments in CD. Studies indicate it improves diagnostic accuracy when used with conventional MRI sequences, providing a complementary, functional dimension to the comprehensive management of this chronic condition. While the functional assessment offered by cine MRI presents a significant advantage over conventional static imaging, its clinical translation is currently challenged by high technical variability. Specifically, there is a distinct lack of standardized acquisition protocols (such as field strength, sequence parameters), post-processing software, and universally validated quantitative motility metrics (such as motility index). Therefore, a primary objective of this review is not only to summarize the evolving diagnostic and monitoring applications of cine MRI but also to critically address the methodological inconsistencies and reproducibility hurdles that must be overcome before this technique can be fully integrated into clinical guidelines for precision management of CD.