[Follow-up of Crohn's disease: can hydro-MRI replace fractionated gastrointestinal passage examination?].
OBJECTIVE
To compare the value of hydro-MRI with follow-through examinations in the follow-up of Crohn's disease.


METHODS
22 patients known to be suffering from Crohn's disease were examined via 1.5 T-MR system; an oral contrast examination using 1000 ml of a 2.5% mannitol solution was performed in all patients. T2-weighted TSE sequences and T1-weighted SE sequences were performed before and after the intravenous injection of Gd-DTPA. To reduce movement artifacts caused by peristalsis of the gut, intravenous injection of 40 mg Buscopan was given. The findings of hydro-MRI were compared with the follow-through examinations.


RESULTS
In the upper gastrointestinal tract, the follow-through examination showed clear advantages compared with hydro-MRI for the demonstration of inflammatory changes in the gut; Hydro-MRI was, however, somewhat more reliable in the ileum and colon. It was also more sensitive than the follow-through for the demonstration of enteric fistulae (four as compared with two cases), and in demonstration extraluminal changes (free fluid in six against zero, and inflammatory adherent loops (four against zero)). Amongst the 22 patients, hydro-MRI was equal (in 10) or better (in 8) than the follow-through examination for demonstrating the intestinal manifestations of Crohn's disease, and follow-through was better in only four.


CONCLUSIONS
For follow-up of Crohn's disease, hydro-MRI is at least as good as follow-through examination, and is even preferable, because of the absence of radiation exposure of the usually young patients.
Schunk
K
K
Klinik und Poliklinik für Radiologie, Klinikum der Johannes Gutenberg-Universität Mainz.
Metzmann
U
U
Kersjes
W
W
Schadmand-Fischer
S
S
Kreitner
K F
KF
Duchmann
R
R
Protzer
U
U
Wanitschke
R
R
Thelen
M
M
D000284:Administration, Oral; D000328:Adult; D001466:Barium Sulfate / Q000008:administration & dosage; D003251:Constriction, Pathologic; D003287:Contrast Media / Q000008:administration & dosage; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004064:Digestive System / Q000000981:diagnostic imaging*; D004733:Enema; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005772:Gastrointestinal Transit; D006801:Humans; D007422:Intestines / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011859:Radiography; D013997:Time Factors
D003287:Contrast Media; D001466:Barium Sulfate