MR enterography
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MR enterography is a non-invasive technique for the diagnosis of small bowel disorders.
Note: This article is intended to outline some general principles of protocol design. The specifics will vary depending on MRI hardware and software, radiologist's and referrer's preference, institutional protocols, patient factors (e.g. allergy), and time constraints.
Indications
MR enterography, similarly to CT enterography, is most commonly used to evaluate patients with Crohn disease where it is used for assessment of the primary disease and any complications. Other indications include coeliac disease, postoperative adhesions, radiation enteritis, scleroderma, small bowel malignancies, and polyposis syndromes.
Advantages
- no ionising radiation
- excellent soft-tissue contrast resolution
- images can be acquired in customised planes
Disadvantages
- longer scanning time
- more susceptible to motion and breathing artefacts
- MR incompatible implants or devices may preclude the scan
Technique
The precise details of the procedure vary depending on local protocol. An example protocol might include 1,2:
Bowel preparation
- abstinence from all food and drink for 4-6 hours prior to the study
- oral administration of 1-1.5 L of2.5% mannitol solution at regular intervals over a period of approximately 40 minutes prior to the study
- hyperosmolar mannitol draws fluid into the bowel
- provides biphasic improved MRI soft tissue contrast:
- low signal intensity on T1-weighted images
- high signal intensity on T2-weighted images
scan using a 1.5 T MRI scannercoil: phased array surface coilposition: supine or prone
MR protocol
Sequences
- comprehensive MR examination of the small bowel usually requires axial and coronal both T1 and T2 weighted images
- high-resolution ultra-fast sequences such as true fast imaging with steady-state precession (true FISP) and HASTE sequences with and without fat suppression are usually used
- fat-suppressed three-dimensional (3D) T1-weighted breath-hold gradient-echo images of the abdomen and pelvis before and after intravenous gadolinium-based contrast material administration
Advantages
no ionising radiationexcellent soft tissue contrast resolutionimages can be acquired in customised planescan detect mural small bowel disorders with possible extramural complications and also allows the detection of the extraintestinal solid organ pathologies
See also
-<p><strong>MR enterography</strong> is a non-invasive technique for diagnosis of small bowel disorders.</p><h4>Indications</h4><p>MR enterography is most commonly used to evaluate patients with <a href="/articles/crohn-disease-1">Crohn disease</a> where it is used for assessment of the primary disease and any complications. Other indications include <a href="/articles/coeliac-disease-1">coeliac disease</a>, postoperative adhesions, <a href="/articles/radiation-enteritis-1">radiation enteritis</a>, <a href="/articles/scleroderma-gastrointestinal-manifestations-1">scleroderma</a>, small bowel malignancies, and <a href="/articles/polyposis-syndromes">polyposis syndromes</a>.</p><h4>Technique</h4><p>The precise details of the procedure vary depending on local protocol. An example protocol might include <sup>1,2</sup>:</p><ul>- +<p><strong>MR enterography</strong> is a non-invasive technique for the diagnosis of small bowel disorders.</p><p><em>Note: This article is intended to outline some general principles of protocol design. The specifics will vary depending on MRI hardware and software, radiologist's and referrer's preference, institutional protocols, patient factors (e.g. allergy), and time constraints. </em></p><h4>Indications</h4><p>MR enterography, similarly to <a href="/articles/ct-enterography">CT enterography</a>, is most commonly used to evaluate patients with <a href="/articles/crohn-disease-1">Crohn disease</a> where it is used for assessment of the primary disease and any complications. Other indications include <a href="/articles/coeliac-disease-1">coeliac disease</a>, postoperative adhesions, <a href="/articles/radiation-induced-enteritis-1">radiation enteritis</a>, <a href="/articles/scleroderma-gastrointestinal-manifestations-1">scleroderma</a>, small bowel malignancies, and <a href="/articles/polyposis-syndromes">polyposis syndromes</a>.</p><h5>Advantages</h5><ul>
- +<li>no <a href="/articles/ionising-radiation">ionising radiation</a>
- +</li>
- +<li>excellent soft-tissue contrast resolution</li>
- +<li>images can be acquired in customised planes</li>
- +</ul><h5>Disadvantages</h5><ul>
- +<li>longer scanning time </li>
- +<li>more susceptible to motion and breathing artefacts</li>
- +<li>MR incompatible implants or devices may preclude the scan</li>
- +</ul><h4>Technique</h4><h5>Bowel preparation</h5><ul>
-<li>scan using a 1.5 T MRI scanner</li>-<li>coil: phased array surface coil</li>-<li>position: supine or prone</li>-</ul><h4>MR protocol</h4><ul>- +</ul><h5>Sequences</h5><ul>
-</ul><p> </p><h4>Advantages</h4><ul>-<li>no ionising radiation</li>-<li>excellent soft tissue contrast resolution</li>-<li>images can be acquired in customised planes</li>-<li>can detect mural small bowel disorders with possible extramural complications and also allows the detection of the extraintestinal solid organ pathologies</li>
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