[MRI with oral filling in patients with chronic inflammatory bowel diseases].
OBJECTIVE
Evaluation of mannitol-MRI in patients with suspected or established Crohn's disease (CD). METHODS. 75 patients with suspected or established Crohn's disease were included. 1.5 l of mannitol-solution were administered orally within 1 h before imaging. A rectal filling was also employed. Butylscopolamin was applied i.v. Native-sequences were acquired. T1w sequences (axial, coronal) were acquired before and after (fs-T1-w-BH) i.v.Gd-DTPA. Additionally a dynamic CM-study was performed.


RESULTS
In 45% of the examinations good image quality was achieved. In 28% opacification of the terminal ileum was insufficient. However, diagnostic assessment was possible. Motion artifacts due to breathing were rare, artifacts due to peristalsis were noted in 16% of the examinations. Alterations indicative to CD were found in 69% of the patients. The SI-increase of the thickened bowel-wall was significantly higher than the increase of not thickened wall (117 vs.75%; p = 0,001 in t-test). We detected stenoses in 56%, fistulas in 23% and an abscess in one patient.


CONCLUSIONS
Mannitol-MRI is a valuable method in the diagnostic work-up of inflammatory bowel disease. Improvement of distal distension should be attempted, because of the good acceptance of the patients and high diagnostical value.
Born
C
C
Institut für Klinische Radiologie/Innenstadt, Klinikum der Universität München, Munich. christine.born@radin.med.uni-muenchen.de
Nagel
B
B
Leinsinger
G
G
Reiser
M
M
D000284:Administration, Oral; D000328:Adult; D016477:Artifacts; D001706:Biopsy; D003113:Colonoscopy; D003287:Contrast Media / Q000008:administration & dosage*; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004234:Diuretics, Osmotic / Q000008:administration & dosage*; D004733:Enema; D005260:Female; D019786:Gadolinium DTPA; D006571:Heterocyclic Compounds; D006801:Humans; D007079:Ileitis / Q000473:pathology; D007082:Ileum / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008353:Mannitol / Q000008:administration & dosage*; D008875:Middle Aged; D015233:Models, Statistical; D009942:Organometallic Compounds; D013997:Time Factors; D014463:Ultrasonography
D003287:Contrast Media; D004234:Diuretics, Osmotic; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; D008353:Mannitol; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate; D019786:Gadolinium DTPA