MR Enteroclysis Imaging of Crohn Disease

Prassopoulos, Panos; Papanikolaou, Nikolaos; Grammatikakis, John; Rousomoustakaki, Maria; Maris, Thomas G.; Gourtsoyiannis, Nicholas

doi:10.1148/radiographics.21.suppl_1.g01oc02s161

Cited by 192 publications

(129 citation statements)

References 12 publications

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“…Chronic inflammatory disease, and in particular, CD, represents the most common application of MRI of small bowel [1][2][3][4][5]8,9,15,[28][29][30][31][32][33][34][35]38] .…”

Section: Inflammatory Bowel Disease (Cd) (Figures 1-4)mentioning

confidence: 99%

“…This sequence, known as true fast imaging with steady-state precession (true-FISP), presents with an intermediate contrast between T1-and T2-weighted images [29,[31][32][33] . Shorter repetition times (TR) are used (< 3 m) and the acquisition time is short.…”

Section: Sequencesmentioning

confidence: 99%

“…Abscesses and phlegmon are well demonstrated at fat-saturated T2-weighted MR imaging and can be distinguished reliably, which aids in management planning. Fistulas and sinus tracts are also depicted, however, the reported sensitivity of MR imaging for depicting sinus tracts is 50%-75% when a conventional enteroclysis study is used as a reference [32,39,45] . Mesenteric lymphadenopathy ranging from 3 to 8 mm in size is depicted at MR imaging with a true fast imaging with steady state precession (FISP) or T2-weighted turbo spin-echo sequence [32,41] .…”

mentioning

confidence: 99%

“…Scores ranging from 0 to approximately 600 with values below 150 are considered as remission and values over 150 as active disease. MR imaging was used to evaluate disease activity [9,[30][31][32][33][34][35]38,41,44,48,49] . Based on different experiences, contrast-enhanced(CE) fat-suppressed T1-weighted images offer the best correlation between MR findings and CDAI, although a correlation that used fatsuppressed T2-weighted images is also demonstrated.…”

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confidence: 99%

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Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications

Zhu¹,

Xu²,

Gong³

et al. 2008

WJG

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High soft tissue contrast resolution, acquisition of multi-planar images and the possibility to obtain functional information make magnetic resonance an interesting imaging technique to evaluate the small bowel disease. The absence of ionizing radiation is an important feature of magnetic resonance imaging (MRI) examinations because inflammatory diseases such as Crohn's disease (CD) are studied most frequently, which are prevalent among children and young adults. MRI, using modern equipment and a rigorous technical approach, can offer detailed morphologic information and functional data on the small bowel. This article discusses the MRI protocols for small bowel and the MR imaging findings of small bowel diseases, such as CD and small bowel neoplasms. There are two main approaches for MRI of the small bowel: (1) study following oral administration of contrast material; and (2) study with distension of lumen obtained with contrast material that is introduced through a naso-jejunal tube (MR enteroclysis). Oral contrast agents for small bowel MRIOral contrast agents can be classified into positive, negative and biphasic categories according to their action on the signal intensity of bowel lumen.A positive agent is a paramagnetic substance that produces a high signal intensity on T1-weighted sequences. It reduces T1 relaxation time without, or only minimally, influencing T2 relaxation time. Because of the water content of the contrast solution, it also results in high signal intensity on T2-weighted images. Positive contrast agents include paramagnetic substances, such as gadolinium chelates, ferrous and manganic ions and manganese ions [12][13][14][15][16] . The use of positive oral contrast agents has been abandoned almost completely because a hyperintense lumen does not enable a clear differentiation with inflammatory parietal enhancement.A negative agent is a substance that produces a low signal intensity on T1-and T2-weighted sequences. These substances induce local inhomogeneity in the magnetic field that affects T1 and T2 relaxation time. T2 effects predominate and are caused by spin dephasing with a consequent loss of signal intensity. Negative contrast agents include perfluorooctyl bromide [17] , iron oxides [15,18] , and oral magnetic particles [14,15] . Barium sulfate, if used at high concentrations, can be considered a negative contrast agent [19] . Negative contrast agents are more favorable if hyperintense signal of the bowel wall and the surrounding fat tissue signs of acute inflammation have to be detected on T2-weighted sequences [15] . However, magnetic susceptibility on gradient echo sequences may alter image quality on breath-held T1-weighted images.The term "biphasic" recently was introduced to define those substances that show different signal intensities depending on different sequences [20] . The first group (hyperintense signal on T1-weighted images and hypointense signal on T2-weighted images) included manganese and substances that contain manganese, and gadolinium chelates, w...

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“…Chronic inflammatory disease, and in particular, CD, represents the most common application of MRI of small bowel [1][2][3][4][5]8,9,15,[28][29][30][31][32][33][34][35]38] .…”

Section: Inflammatory Bowel Disease (Cd) (Figures 1-4)mentioning

confidence: 99%

Section: Sequencesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications

Zhu¹,

Xu²,

Gong³

et al. 2008

WJG

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show abstract

“…As with most diagnostic imaging tools, there are some shortcomingsofMRI.First,peoplewithpacemakers,internal defibrillatorsandaneurysmclipsarenotabletobescanned, for obvious safety concerns, while those people who suffer from claustrophobia may not be able to tolerate the enclosed spaceofthemagnetbore.Second,thespatialresolutionofMRI iswellbelowthatofCT 10 andthird,CTismorewidelyavailable, hasashorterexaminationtime(reducingmotionartifact)andis cheaperthanMRI. 5,6 MR enteroclysis Rather than the patient drinking the oral contrast, it can be infusedintothesmallbowelviaanaso-jejunalcatheter.Thisis known as MR enteroclysis.…”

Section: Disadvantages Of Mrimentioning

confidence: 99%

MR imaging of Crohn's disease: The experience at the Royal Melbourne Hospital

Perry

2005

Radiographer

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Experience at our hospital departmentDuringtheperiodOctober2001toNovember200,weperformed 80 MRI examinations on 73 patients (seven had two scans) for Crohn's disease. Forty-eight of the patients were female (66%) and 25 patients male (3%). The average age of the female patients was 38 years (range 17-81) and the male IntroductionCrohn's disease is a chronic inflammatory bowel disease affectingthegastro-intestinal(GI)tractanywherefromthemouth totheanus.Thesmallbowelisaffectedin80%ofcases,most commonlyattheterminalileum.1 Thelargebowelisalsoaffected (20% of the time alone and 50% of the time with the small bowel).2 Thediseaseischaracterisedby'skip'lesionsofnormal and diseased bowel, epitheloid cell granulomas and transmural inflammationoftheaffectedareas.Symptomsincludeabdominalpain,diarrhoea,rectalbleeding, fevers and weight loss and gross pathologic findings include: inflamedbowelwall,enlargedmesentericlymphnodesandthe formationofabdominalandpelvicfistulas. 3ItisacharacteristicofCrohn'sdiseaseforsuffererstoundergo periods of remission and relapse, 1 and it is also not unusual for these patients to undergo surgery to remove affected segments ofbowel.Thecauseofthediseaseisunknownanditmostcommonlyaffectsyoungadults.The medical management of Crohn's disease depends upon on the severity and status of the disease. Medication given to helpmanagetheinflammatoryresponseofthebowelaswellas bacterial over-growth include: immunosuppressants, antiinflammatoriesandantibiotics. Hospital practice and methodologyOurprotocolforacomprehensivemagneticresonanceimaging(MRI)examinationofthesmallbowelincludesbothT1and T2 weighted imaging sequences and post-contrast T1 weighted images.3,5 As with a computer ised tomography (CT) examinationoftheabdomenandpelvis,itisveryimportanttoutiliseoral contrastpriortothescaninordertoadequatelydistendthebowel loops, thus allowing for correct assessment of disease activity withinthebowelwall.3 Atourdepartmentthepatientdrinks1Lof abarium-sulphatesuspension(Redicat ® -2)whichappearsaslowsignalintensityonT1-weightedimagesandhigh-signalintensity on T2-weighted images. We also distend the large bowel with 700mlofwateradministeredasanenema.Thepatientmustalso MR imaging of Crohn

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Magnetic Resonance Imaging of the Gastrointestinal Tract

Low

2004

CP Magnetic Resonance Imaging

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The early focus in body MR imaging was on imaging solid visceral organs, such as the liver and kidney. MRI of the extrahepatic abdomen, including the gastrointestinal (GI) tract, posed significant challenges related to motion artifacts and long exam times. However, new advances in MR imaging hardware and software have overcome all of these challenges, so that MR imaging of the GI tract has evolved to become a powerful and robust imaging technique. The improved efficiency of new MR scanners and software allows one to image the abdomen and pelvis rapidly using breath-hold sequences. The excellent contrast conspicuity of MR imaging when combined with gadolinium chelates and intraluminal contrast material facilitates depiction of mural diseases of the stomach, small intestine, and colon ( Fig.

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MR Enteroclysis Imaging of Crohn Disease

Cited by 192 publications

References 12 publications

Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications

Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications

MR imaging of Crohn's disease: The experience at the Royal Melbourne Hospital

Magnetic Resonance Imaging of the Gastrointestinal Tract

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