title: Use of small bowel MRI enteroclysis in the management of paediatric IBD.
abstract: BACKGROUND
  Children with inflammatory bowel disease (IBD) frequently present with small bowel involvement at some stage of their disease. Hence, reliable assessment of the entire small bowel is required in order to adjust treatment accordingly. Recently, magnetic resonance imaging (MRI) of the small bowel in combination with luminal contrast agent delivered via a naso-jejunal tube (MR enteroclysis) is an emerging technique demonstrating good results in adult patients. However, data on its use and benefits in children is limited.
  
  
  OBJECTIVE
  In this study we report our experience on performing small bowel MR enteroclysis (MRE) in children with IBD. Specifically, we reviewed indications, MR findings, advantages and disadvantages of the technique in a tertiary unit.
  
  
  METHODS
  A total of 34 MRE studies (29 paediatric IBD patients) were retrospectively analysed. All patients underwent upper and lower endoscopy under general anaesthetic (GA) the day before MR imaging was performed. Nasojejunal (NJ)-tube was placed during endoscopy.
  
  
  RESULTS
  Frequently detected findings included small and large bowel wall thickening, small bowel strictures and intestinal lymph node enlargement. Importantly, in all our clinical cases, MRE results were key to making a clinical decision in the given scenario regardless of whether MRE findings were positive or negative.
  
  
  CONCLUSIONS
  Within our setup, MR enteroclysis is a well-tolerated, sensitive technique for small bowel imaging, providing detailed information at crucial clinical decision points. Moreover, accurate information then allows appropriate clinical decisions to be made.
authors.affiliation: Department of Paediatric Gastroenterology, Hepatology & Nutrition, Addenbrooke's Hospital, Cambridge University, Cambridge, UK.
authors.forename: S
authors.initials: S
authors.lastname: Sanka
authors.forename: A
authors.initials: A
authors.lastname: Gomez
authors.forename: P
authors.initials: P
authors.lastname: Set
authors.forename: N
authors.initials: N
authors.lastname: Rimareva
authors.forename: R J
authors.initials: RJ
authors.lastname: Davies
authors.forename: P
authors.initials: P
authors.lastname: Rolfe
authors.forename: G
authors.initials: G
authors.lastname: Noble-Jamieson
authors.forename: F
authors.initials: F
authors.lastname: Torrente
authors.forename: R
authors.initials: R
authors.lastname: Heuschkel
authors.forename: M
authors.initials: M
authors.lastname: Zilbauer
mesh_terms: D000293:Adolescent; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000628:therapy; D007421:Intestine, Small / Q000473:pathology*; D007441:Intubation, Gastrointestinal; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media