Share：
Share this content in WeChat
X
[Chinese][PDF]95291
• Clinical Article •
MR enterography with oral isosmotic mannitol
REN Xiao-jun  ZHANG Shi-zheng  ZHANG Qiao-wei 

DOI:10.3969/j.issn.1674-8034.2013.06.002.


[Abstract] Objective: To discuss the method and diagnostic value of MR entero-graphy with oral isosmotic mannitol.Materials and Methods: Twenty-six patients with suspected small bowel disease received MR enterography. All patients ingested 1500 ml of 2.5% isosmotic mannitol solution in succession as intraluminal contrast media and received 20 mg of IV anisodamine to reduce small-bowel peristalsis before MR scan. MRI sequences included: fat-saturated unenhanced coronal T2-weighted single-shot FSE (SSFSE), T1 weighted coronal fast spoiled gradient echo (FSPGR) and enhanced coronal and axial FSPGR. The side effects were recorded and the image quality was graded as bad, good and excellent. Comparison of the results between MR enterography and surgery, pathology or clinic was performed.Results: MR enterography was well tolerated by all patients. No side effect occured except 2 patients had mild nausea during the examination. Good or excellent filling and distension were obtained in ileum and distal jejunum in 26 patients (100%) and in proximal jejunum in 22 patients (85%), and bad filling and distension in proximal jejunum in the other 4 patients (15%). All image quality was excellent because of no breathing artifact and bowel peristaltic artifact in all patients and mild sensibility artifact in 2 patients. The final clinical diagnosis was normal small bowel in 12 patients, Crohn disease in 7, bowel obstruction (caused by adhesion), duodenal carcinoma, multiple gastro intestinal stroma tumor (GIST), duodenitis, duodenocolic fistula, jejunal capillary telangietasia and small intestinal malrotation in 1 patient, respectively. No abnormality was found in 1 intestinal capillary telangietasia, the other diagnosis of MR enterography was coincident with the final clinical diagnosis, and the diagnostic accuracy was 96%.Conclusion: MR enterography with oral isosmotic mannitol is a feasible and dependable method to diagnose small bowel disease, especially Crohn disease, tumor and obstruction.
[Keywords] Magnetic resonance imaging；Intestine, small；Intestinal disease

REN Xiao-jun Department of Radiology, Xidian group hospital, Xi’an 710077, China

ZHANG Shi-zheng * Sir Run-Run Shaw Hospital, Medical School, Zhejiang University, Hangzhou 310016, China

ZHANG Qiao-wei Sir Run-Run Shaw Hospital, Medical School, Zhejiang University, Hangzhou 310016, China

*Correspondence to: Zhang SZ, E-mail: cjr.zhshzh@vip.163.com

Conflicts of interest   None.

Received  2013-07-26
Accepted  2013-09-22
DOI: 10.3969/j.issn.1674-8034.2013.06.002
DOI:10.3969/j.issn.1674-8034.2013.06.002.

[1]
任小军，章士正，张峭巍，等．小肠Crohn病的MRI诊断．中华放射学杂志, 2004, 38(11): 1201-1205.
[2]
赖灿，周海春．儿童小肠MR成像临床应用评价．磁共振成像, 2012, 3(3): 188-193.
[3]
Ian CL, Christopher JW, Peter S, et al. Small bowel MRI enteroclysis or follow through: which is optimal? World J Gastroenterol, 2009, 15(42): 5300-5306.
[4]
Negaard A, Paulsen V, Sandvik L, et al. A prospective randomized comparison between two MRI studies of the small bowel in Crohn’s disease, the oral contrast method and MR enteroclysis. Eur Radiol, 2007, 17 (9): 2294-2301.
[5]
Masselli G, Gualdi G. Evaluation of small bowel tumors: MR enteroclysis. Abdom Imaging, 2010, 35(1): 23-30.
[6]
章士正，任小军，周合山．小肠磁共振水成像的诊断价值．中国医学计算机成像杂志, 2003, 9(6): 421-425.
[7]
章士正，任小军，张峭巍. MR注气小肠灌肠检查对小肠疾病的诊断价值．中华放射学杂志, 2004, 38(5): 489-493.
[8]
任小军，章士正. MR注气小肠灌肠及水成像对小肠疾病诊断价值的比较．放射学实践, 2006, 21(3): 223-227.
[9]
Ian CL, Christopher JW, Peter S, et al. Small bowel MRI enteroclysis or follow through: Which is optimal? World J Gastroenterol, 2009, 15(42): 5300-5306.
[10]
Roberto M, Riccardo M, Luigi B, et al. Assessment of Crohn s disease activity in the small bowel with MR-enteroclysis: clinico-radiological correlations. Abdom Imaging, 2008, 33(6): 669-675.
[11]
Van Weyenberg SJ, Meijerink MR, Jacobs MA, et al. MR enteroclysis in the diagnosis of small-bowel neoplasms. Radiology. 2010, 254(3): 765-773.
[12]
Schmid TC, Agrawal G, Dahi F, et al. Diffusion-weighted MRI: role in detecting abdominopelvic internal fistulas and sinus tracts. J Magn Reson Imaging, 2012, 35 (1): 125-131.
[13]
Aytekin O, Fang Z, Kirti K, et al. Evaluation of diffusion-weighted MR imaging for detection of bowel inflammation in patients with Crohn’s disease. Acad Radiol, 2009, 16 (5): 597-603.
[14]
Jasper F, Martin NJ, Kasia A, et al. Dynamic contrast-enhanced MRI of the bowel wall for assessment of disease activity in Crohn’s disease. AJR Am J Rpentgenol, 2006, 186(5): 1384-1392.
[15]
Sabina G, Lorenzo F, Emanuele N, et al. Dynamic MRI of the small bowel: usefulness of quantitative contrast-enhancement parameters and time-signal intensity curves for differentiating between active and inactive Crohn’s disease. Abdom Imaging, 2010, 35(6): 646-653.

PREV Display of 3.0 T magnetic resonance in normal pancreatic direct supplying arteries
NEXT High-resolution MRI study of middle cerebral artery stenosis rate differences in infarct and TIA patients
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn