Learning objectives
Present the technical challenges of MR Enteroclysis Describe the pros and cons of the pulse sequences used in MR Enteroclysis Recognize the artifacts on MR Enteroclysis images Introduce a comprehensive MR Enteroclysis examination protocol
Background
With the advent of gradient systems the image quality of already existing ultrafast pulse sequences i.e. HASTE, true FISP and FLASH improved substantially and clinical applications including small bowel imaging became feasible. Within this context, MR Enteroclysis was developed, as a comprehensive examination of the small bowel, providing luminal, transmural and exoenteric diagnostic information of small bowel diseases.
Imaging findings OR Procedure details
Software and Hardware for MR Enteroclysis Ultrafast pulse sequences should be utilized to reduce motion related artifacts arising from physiological motion (respiration and peristalsis) in the abdominal area. The spatial resolution of these sequences should be high enough to permitt demonstration of small lesions i.e. ulcers, that are usually present in small bowel diseases. The inherent poor signal to noise ratio of these sequences has to be increased to reach a clinically acceptable image quality.High field strength magnets (>1 Tesla) have better intrinsic signal to...
Conclusion
In conclusion, MR imaging has a potential to change how we evaluate the small intestine, because of its superb soft tissue contrast and functional information it can provide, its direct multiplanar capabilities and the lack of radiation exposure. Adequate bowel distention, homogeneous lumen opacification, fast sequences with breath hold acquisition times, both T1- and T2-weighted imaging and contrast enhancement are cornerstones for an optimal MRI examination of the small bowel. A comprehensive MR Enteroclysis imaging protocol should comprise SSTSE, true FISP, HASTE and fat suppressed...
References
Umschaden HW, Szolar D, Gasser J, Umschaden M, Haselbach H. Small-Bowel Disease: Comparison of MR Enteroclysis Images with Conventional Enteroclysis and Surgical Findings. Radiology 2000;215:717-7125. Schunk K, Metzmann U, Kersjes W, Schadmann-Fischer S, Kreitner KF, Duchmann R, Protzer U, Wanitschke R, Thelen M. Serial observation in Crohns disease: Can hydro-MRI replace follow-through examinations? Fortschr Rntgenstr 1997;166: 389-396. Maccioni F, Viscido A, Broglia L, Marrollo M, Masciangelo R, Caprilli R, Rossi P. Evaluation of Crohns disease activity with magnetic resonance imaging. Abdom Imaging 2000; 25:219-228. Gourtsoyiannis...
Personal Information
N. Papanikolaou, M.Sc., Biomedical Engineer,University Hospital of Heraklion,
[email protected]. PrassopoulosProfessor of Radiology, University of AlexendropoliI. Grammatikakis, Senior RadiologistG. Papamastorakis, Resident in RadiologyT.G. Maris, Ph.D. MR PhysicistN. Gourtsoyiannis Professor and Chairman, Departmentof Radiology, University Hospital of Heraklion, Crete, Greece