Polyethylene glycol and contrast-enhanced MRI of Crohn's disease in children: preliminary experience.
OBJECTIVE
To assess the ability of MRI to detect bowel abnormalities in children affected by Crohn's disease (CD).


METHODS
We studied 22 children (age range 8-18 years) referred to us with a known history of CD. MRI was carried out using a 1.5-T unit with a maximum gradient field strength of 16 mT and a phased-array body coil. The sequences performed were breath-hold coronal and axial T2-weighted, express fat saturation, followed by T1-weighted, spoiled gradient, fast fat saturation after IV injection of gadolinium chelate (0.3 mmol/kg) for contrast enhancement of the bowel wall. Bowel distension was achieved using oral administration of isosmotic polyethylene glycol solution. Ileo-colonoscopy was considered the gold standard for evaluation of superficial abnormalities and stenoses of the colon and terminal ileum. MRI findings of bowel-wall thickening, increased vascularisation and extramural involvement were compared with the findings using B-mode and Doppler US. Concordance between MRI and endoscopy, B-mode US and Doppler US findings was determined by the Kappa statistical method.


RESULTS
Superficial lesions were not shown by MRI. MR enteroclysis easily detected stenoses, thickening and hyperaemia of bowel wall. Concordance of findings between MRI and endoscopy was 90% (K=0.79, substantial concordance). Concordance of findings between MRI and US concerning bowel-wall thickening and increased vascularisation was 95% (K=0.875, excellent concordance) and 80% (K=0.6, fairly good concordance), respectively.


CONCLUSIONS
Our initial results show that MRI can detect intra- and extra-mural lesions of CD. The high concordance observed between MRI, endoscopy, US and Doppler US findings suggests that MRI is at least comparable for diagnostic capability with these techniques offering, thanks to multiplanar projections, an improved visualisation of the bowel without ionising radiation.
Magnano
Gianmichele
G
Service of Radiology, Giannina Gaslini Hospital, Genoa, Italy.
Granata
Claudio
C
Barabino
Arrigo
A
Magnaguagno
Francesca
F
Rossi
Umberto
U
Calevo
Maria Grazia
MG
Toma
Paolo
P
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007420:Intestine, Large / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011092:Polyethylene Glycols; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler
D003287:Contrast Media; D011092:Polyethylene Glycols; D019786:Gadolinium DTPA