Perianal Crohn’s disease (pCD) is a potential complication of CD patients. Disease monitoring is imprecise due to unreliable clinical scores and subjective radiological reporting. Quantitative MRI sequences, e.g. diffusion-weighted image (DWI), dynamic contrast enhancement (DCE), magnetization transfer (MT) and T2 relaxometry offer opportunities to improve diagnostic capability. This study aimed to attain pilot data regarding the diagnostic utility of these sequences before and after 12 weeks of biological treatment in active pCD. Significant negative correlation was found between MTR and T2, MTR and DCE parameter ktrans and MTR with apparent diffusion coefficient, reflecting competing disease effects of inflammation and fibrosis.