title: Magnetic resonance imaging in children and adolescents with chronic inflammatory bowel disease.
abstract: Inflammatory bowel diseases (IBD) represent challenges, both from a diagnostic, and therapeutic point of view. Deep-seated anatomic structures are difficult to assess by ultrasound technique alone. As radiation-free alternative cross-sectional imaging method, magnetic resonance imaging of the intestinal structures is costly and time-consuming. Examination of pediatric patients imply additional considerations: reduction of body motions in younger children and consideration of the most appropriate preparation, and examination technique. The demanding Sellink technique is the only means for appropriately distending the lesser intestine in order to detect small bowel strictures. Oral intake of contrast medium (CM) alone shows its limitations regarding distensibility. The need for intravenous contrast media application needs to be considered, too. Active inflammation of both intestinal wall, and mesentery can be demonstrated accurately. Nevertheless, viable alternatives to CM application is desirable, considering non-negligible adverse reactions. Recent data suggest diffusion weighted imaging might fill this diagnostic gap. Irrespective of sequence technique chosen, bowel movement remains a major obstacle. Antispasmolytics in their function as smooth muscle relaxants help in improving image quality, however, their use in children might be off-label. Optimal preparation for the examination and appropriate imaging technique allow for diagnosing typical patterns of changes in IBD, such as bowel wall thickening, ulcers, mural stratification, strictures, creeping fat, and comb sign, and lymphadenopathy. The article gives a detailed overview of current significance of magnetic resonance imaging pediatric patients suffering from IBD, considering indications, limitations, and safety aspects.
authors.affiliation: Hans-Joachim Mentzel, Martin Stenzel, Section of Pediatric Radiology, Department of Radiology, University Hospital Jena-Friedrich-Schiller-University Jena, 07740 Jena, Germany.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Mentzel
authors.affiliation: Hans-Joachim Mentzel, Martin Stenzel, Section of Pediatric Radiology, Department of Radiology, University Hospital Jena-Friedrich-Schiller-University Jena, 07740 Jena, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Reinsch
authors.affiliation: Hans-Joachim Mentzel, Martin Stenzel, Section of Pediatric Radiology, Department of Radiology, University Hospital Jena-Friedrich-Schiller-University Jena, 07740 Jena, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Kurzai
authors.affiliation: Hans-Joachim Mentzel, Martin Stenzel, Section of Pediatric Radiology, Department of Radiology, University Hospital Jena-Friedrich-Schiller-University Jena, 07740 Jena, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Stenzel
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D003093:Colitis, Ulcerative / Q000473:pathology*; D003287:Contrast Media; D003424:Crohn Disease / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000009:adverse effects; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D003287:Contrast Media
keywords: Adolescents; Children; Crohn’s disease; Enterography; Inflammatory bowel disease; Magnetic resonance imaging; Ulcerative colitis