Hydro-MRI of the Small Bowel: Effect of Contrast Volume, Timing of Contrast Administration, and Data Acquisition on Bowel Distention

Kuehle, Christiane A.; Ajaj, Waleed; Ladd, Susanne C.; Massing, S.; Barkhausen, Joerg; Lauenstein, Thomas C.

doi:10.2214/ajr.05.1079

Cited by 115 publications

(94 citation statements)

References 32 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although Mannitol was used in this study for clear visual confirmation of the effect of glucagon, the tagging sequence provides its own contrast and the method of motion sampling does not require bowel distention. Combined with the ability to sample motion during free breathing the low dependence on bowel preparation schemes will increase the patient acceptance of the method, as bowel preparation is often considered burdensome (19,20). Furthermore, bowel motion can be sampled during all motility periods related to the complete digestive process and during both wake and sleeping states with relative ease.…”

Section: Discussionmentioning

confidence: 99%

Use of continuously MR tagged imaging for automated motion assessment in the abdomen: A feasibility study

Sprengers

Paardt

Zijta

et al. 2012

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose: To investigate the feasibility of measuring motion in the abdomen using a continuously tagged magnetic resonance imaging sequence. Materials and Methods:To assess (nonperiodic) motion in the abdomen, a nontriggered, continuously tagged transient field echo (TFE) sequence was implemented that acquires one complete 3D dataset per prepulse after a fixed delay. In postprocessing, a frequency analysis approach was developed for compact reviewing of the data and noise suppression. For proof of principle, a simulation was made and one free-breathing dynamic in vivo scan was acquired in a healthy volunteer. During the dynamic scan the volunteer received glucagon intravenously. Results:The simulation showed that this frequency analysis enables the extraction of motion at low signal-tonoise ratio levels. Motion information was successfully gathered from the in vivo scan. The decline in bowel motion caused by the administration of glucagon could be quantitatively measured using the continuously tagged sequence. Conclusion:Continuously tagged imaging in the abdomen for the purpose of automated gathering of motion information is feasible and could aid the study of bowel motion.

show abstract

Section: Discussionmentioning

confidence: 99%

Use of continuously MR tagged imaging for automated motion assessment in the abdomen: A feasibility study

Sprengers

Paardt

Zijta

et al. 2012

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…Milk was shown to give similar results as Volumen [13], but although less expensive and freely available in Europe, it may be deemed unpalatable by many patients when drunk in large volumes. Kuehle et al [14] reported that good small bowel distension could be achieved when using a 1-l solution of 2.5% mannitol/0.2% locust bean gum prior to MR enterography, with relatively minimal side effects. However, they found increased side effects such as diarrhoea, vomiting and spasms with increasing volumes (1200 and 1500 ml), without any significant improvement in small bowel distension.…”

Section: Luminal Contrast and Distensionmentioning

confidence: 99%

CT enterography: review of technique and practical tips

Ilangovan¹,

Burling²,

George³

et al. 2012

BJR

View full text Add to dashboard Cite

ABSTRACT. CT enterography is a new non-invasive imaging technique that offers superior small bowel visualisation compared with standard abdomino-pelvic CT, and provides complementary diagnostic information to capsule endoscopy and MRI enterography. CT enterography is well tolerated by patients and enables accurate, efficient assessment of pathology arising from the small bowel wall or surrounding organs. This article reviews the clinical role of CT enterography, and offers practical tips for optimising technique and accurate interpretation. Until recently, diagnosis of small bowel pathology had relied primarily on radiological techniques, in part due to the relative inaccessibility of the small bowel to conventional endoscopy. However, new endoscopic developments-notably the recent introduction of capsule endoscopy and double balloon enteroscopy-are challenging this position. Capsule endoscopy, for example, is now generally accepted as first-line investigation for occult gastrointestinal haemorrhage, and increasingly advocated for diagnosis of early Crohn's disease. However, the radiological community has not stood still. In parallel with the development of new endoscopic techniques, rapid progress has been made in crosssectional imaging technologies, harnessing the power of multidetector row CT (MDCT), MRI and ultrasound, facilitating rapid, accurate and minimally invasive investigation of the small bowel and adjacent tissues.CT enterography was first introduced by Raptopoulos et al [1] in 1997 as a modification to ''standard'' abdomino-pelvic CT examination to specifically examine the small bowel in detail, notably to assess the extent and severity of Crohn's disease [1,2]. They combined neutral (low-density) oral contrast with ''enteric phase'' CT to optimise contrast resolution between mucosa and lumen, thereby maximising conspicuity of abnormalities arising from the small bowel wall. Several authors have subsequently described similar techniques, which are broadly categorised into CT enterography (where patients drink oral contrast) and CT enteroclysis (luminal contrast is introduced via a nasojejunal tube placed fluoroscopically prior to CT examination). Although superior jejunal distension is attained using enteroclysis, the convenience, efficiency and superior patient experience achieved with CT enterography make it the preferred technique at the authors' institutions, and therefore the focus of this review. This paper will critically review the CT enterography technique and provide practical tips on interpretation to assist radiologists and help them avoid common interpretative pitfalls. We will also examine its role relative to other complementary non-ionising radiation radiological tests. TechniqueThe technique of CT enterography combines small bowel distension with a neutral or low-density oral contrast mixture and abdomino-pelvic CT examination during the enteric phase following administration of intravenous contrast. Patients drink approximately 1.5-2 l of oral contrast over 45-60 min. Patient comp...

show abstract

“…In the previously mentioned study from Essen, water, locust bean gum with 5% mannitol, and VoLumen with 1.4% sorbitol and 2% sorbitol were ingested [25]. Regardless of the agent, volumes of up to 1350 mL were associated with no or only mild side effects or objections.…”

Section: Oral Contrast Agent Choicementioning

confidence: 92%

“…This results in the patient ingesting 1350 cc of liquid. In a study from Essen, investigators found that a volume of 1350 cc was preferable for optimal small bowel distension; ingestion of 1800 cc led to a significantly higher rate of cramping and diarrhea; 900 cc yielded sufficient duodenal distension, if imaged soon after ingestion, but led to less jejunal and ileal distension [25]. In this investigation, the subjects were timed with a stopwatch and ingested the oral agents at a rate of 40 mL/min, an extremely regimented protocol and likely not clinically achievable!…”

Section: Workflow Set-up and Patient Supervisionmentioning

confidence: 99%

See 1 more Smart Citation

CT enterography for Crohn’s disease: optimal technique and imaging issues

et al. 2015

View full text Add to dashboard Cite

CT enterography (CTE) is a common examination for patients with Crohn's disease. In order to achieve high quality, diagnostic images, proper technique is required. The purpose of this treatise is to review the processes and techniques that can optimize CTE for patients with suspected or known Crohn's disease. We will review the following: (1) how to start a CT enterography program; (2) workflow issues, including patient and ordering physician education and preparation; (3) oral contrast media options and administration regimens; (4) intravenous contrast media injection for uniphasic and multiphasic studies; (5) CTE radiation dose reduction strategies and the use of iterative reconstruction in lower dose examinations; (6) image reconstruction and interpretation; (7) imaging Crohn's patients in the acute or emergency department setting; (8) limitations of CTE as well as alternatives such as MRE or barium fluoroscopic examinations; and (9) dictation templates and a common nomenclature for reporting findings of CTE in Crohn's disease. Many of the issues discussed are summarized in the Abdominal Radiology Society Consensus MDCT Enterography Acquisition Protocol for Crohn's Disease.

show abstract

Hydro-MRI of the Small Bowel: Effect of Contrast Volume, Timing of Contrast Administration, and Data Acquisition on Bowel Distention

Abstract: The data indicate that sufficient contrast consumption and optimal timing of data acquisition are essential to distention of the small bowel. Oral contrast agent protocols should be adapted to the bowel region in question.

Cited by 115 publications

References 32 publications

Use of continuously MR tagged imaging for automated motion assessment in the abdomen: A feasibility study

Use of continuously MR tagged imaging for automated motion assessment in the abdomen: A feasibility study

CT enterography: review of technique and practical tips

CT enterography for Crohn’s disease: optimal technique and imaging issues

Contact Info

Product

Resources

About