MR enteroclysis protocol optimization: comparison between 3D FLASH with fat saturation after intravenous gadolinium injection and true FISP sequences

Abstract

The aim of this study was to introduce the true fast imaging with steady-state precession (FISP) sequence for MR enteroclysis and compare it with the already used T1-weighted fast low-angle shot (FLASH) sequence. Twenty-one patients underwent both MR and conventional enteroclysis. The MR enteroclysis examination was performed after administration of an iso-osmotic water solution through a nasojejunal catheter and the following sequences were included: (a) true FISP; and (b) 3D FLASH with fat saturation after intravenous injection of 20 mg Buscopan or 1 mg glucagon and 0.1 mmol/kg gadolinium chelates. The true FISP sequence provided images with significantly fewer motion artifacts, whereas 3D FLASH was less sensitive to susceptibility and chemical shift artifacts. The homogeneity of endoluminal opacification, wall conspicuity, and distention of the small bowel were very good to excellent and the two sequences presented no statistically significant differences here. True FISP provided significantly better overall image quality than did 3D FLASH. The true FISP sequence can provide good anatomic demonstration of the small bowel on T2-like images and could be combined with T1-weighted FLASH images for an integrated protocol of MR enteroclysis.

Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension

“…Similarly, the abdomen can be depicted on fat-saturated 3D gradient-echo sequences in conjunction with the intravenous administration of T1-shortening contrast agents [22]. To be suited for small bowel MRI both sequence types rely on the presence of intestinal contrast for delineation and distension of individual bowel loops [23]. The underlying contrast characteristics call for a distending agent characterized by bright signal on T2-weighted images and dark signal on T1-weighted data sets.…”

“…In view of the desired contrast properties, water appears to be ideal as an MR contrast agent for delineation of the small bowel [12,23,26,28,29]. To assure adequate small bowel distension, the rapid physiological absorption of water needs to be delayed [29]; thus, suitable additives preventing, or at least delaying the absorption of water are desirable.…”

Juxtapapillary diverticulum: Findings on MRI

“…In our study, this technique enabled better delineation of the diverticular wall. It has been shown that the use of either of these techniques may be useful in the demonstration of bowel pathology (16,17).…”

Malignant tumours of the small intestine: a review of histopathology, multidetector CT and MRI aspects

“…The speed and motion insensitivity of the acquisition completely eliminates breathing or peristalsis induced artefacts [17,26]. Unlike the halfFourier technique, intraluminal flow voids do not affect steady-state precession sequences; moreover, selective fat-suppression pulses can be used to increase the luminographic effect and remove ''black boundary'' artefacts caused by magnetic susceptibility [27,28].…”

“…These T 1 weighted sequences can be acquired as two dimensional (fewer motion artefacts) or 3D (higher spatial resolution) data sets. Their use after intravenous Gd administration permits excellent depiction of the mesenteric vessels and identification of hypervascular bowel walls if coupled with a selective spectral fatsuppression pulse [27,29,30].…”