 A T2-weighted MR sequence with fat-suppression sequences is the current advised technique for MR fistula imaging. This forms the basis of the Van Assche 1 score. This MR-based score was suggested to provide combined information of anatomical fistula description and features reflecting inflammatory activity. The score is insensitive to clinical response, with no significant difference shown in clinical responders to anti-tumor necrosis factor anti-TNF therapy before and 6 weeks after treatment, nor was there a difference in the score between clinical responders and non-responders. Longer term studies replicated these findings and also showed a dis-concordance of at least 12 months between clinical and radiological remission. T1-weighted gadolinium-enhanced images did not change significantly before or after treatment . No correlation was found between these MR-based measures of fistula activity and other known markers of disease activity like C-reactive protein and the PDAI. 