Magnetic Resonance enteroclysis imaging in Crohn's disease.
OBJECTIVE
To assess the role of magnetic resonance enteroclysis (MRE) in patients with Crohn's disease, in order to identify involved segments, define the extension and evaluate transmural alterations.


METHODS
Eighteen patients with known Crohn's disease were studied with MR (1.5 T), with breath-hold T2-weighted TSE, T2-weighted TSE SPIR and 3D T1-weighted sequences before and after gadolinium injection (0.2 mmol/kg) in the coronal and axial planes. The small bowel was distended by the administration of 2 l of methylcellulose through a nasojejunal tube and drug induced hypotony. Typical patterns of Crohn's disease, such as mucosal abnormalities, parietal thickening and narrowing of the bowel, prestenotic dilation, fibrofatty proliferation and enlarged lymph nodes were analysed on radiological and MRE images. MRE was performed within 30 days from conventional radiological studies (conventional enteroclysis and small bowel follow-through).


RESULTS
Good distension of the bowel wall was obtained in all cases. MRE assessed the presence of parietal thickening and narrowing of the bowel wall (14/18 cases) and the presence of prestenotic dilatation (12/18 cases). Vascular enhancement (14/18 cases), transmural abnormalities (8/18 cases), fibrofatty proliferation (3/18 cases), abscess formation (2/18 cases) and enlarged mesenteric lymph nodes (6/18 cases) were also observed. MRE missed small fistulas which were visible in radiological studies in two patients.


CONCLUSIONS
MRE appears to be a promising technique in patients with Crohn's disease. Due to limited spatial resolution MRE could be a useful adjunct to radiological studies and in following up selected groups of patients with prior known disease.
Broglia
Laura
L
UOC Radiologia Interventistica e dell'Alta Tecnologia, Azienda Complesso Ospedaliero S. Filippo Neri, Rome, Italy. laura.broglia@tin.it
Gigante
Paola
P
Papi
Claudio
C
Ferrari
Riccardo
R
Gili
Loredana
L
Capurso
Lucio
L
Castrucci
Marco
M
D000328:Adult; D002482:Cellulose / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage; D003424:Crohn Disease / Q000473:pathology*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged
D003287:Contrast Media; D002482:Cellulose