Learning objectives
In this presentation,
we provide a distinction between the usefulness of MR Enterography (MRE) and Small Bowel Follow Through (SBFT) and demonstrate through examples the preparation prior to the acquisition of the study,
the most used resonance sequences for the different pathologies of the digestive tract,
the contrast media used,
the acquisition and post-processing of the images.
Finally,
we aim at describing a reliable protocol well-tolerated by patients and easy to implement
Background
We treated 1152 patients with presumptive diagnosis of inflammatory pathologies from May,
2012,
to the date of development of this study resulting in proven pathological findings.
We normally examine patients with Crohn's Disease (CD) (for assessment of the primary disease and its complications),
Ulcerative Colitis (UC),
celiac disease,
postoperative adhesions,
enteritis,
small bowel malignancies,
active ileitis and polyposis syndromes.
Computed Tomography and traditional SBFT result in high radiation doses due to the young age of patients suffering from CD or UC and to the chronic...
Findings and procedure details
Pathological Findings
Diagnostic images of polyps,
inflammatory pathologies,
fistulas,
abscesses,
jejunal stenosis,
transient invaginations in celiac disease,
among others,
were obtained by applying acquisition techniques using oral and intravenous contrast,
MR sequences: Balanced,
T2,
DWI + ADC and dynamic T1 volumetric 3D with fat suppression pre- and post-intravenous contrast.
Patient Preparation
At our institution,
we use oral contrast (a single 500 cm3 packet of Mannitol 15% diluted in 1500 ml of water) to achieve optimal distension of the bowel.
The patient is indicated to swallow...
Conclusion
Based on the optimization of the correct methods for patient preparation and acquisition of the study and on the correct setting of sequence parameters,
it is possible to establish replicable protocols,
reliable and easy to implement.
We can favor the acquisition of fast images that lead to improvements of post-processed images for pathologies presentation and categorization.
With the advantage of an accurate diagnosis avoiding doses of ionizing radiation typical of conventional computed tomography or radiology and the option of obtaining mural and extramural images simultaneously...
Personal information
Dipl.-Phys.
Lagonegro Anderson Diego
Department of Diagnostic Imaging - MRI
Hospital Alemán de Buenos Aires
1640 Pueyrredon Ave.
TN (+54 11) 4827 7000 Ext.
2775
[email protected]
References
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Evaluation of Microvascular Permeability with Dynamic Contrast-Enhanced MRI for the Differentiation of PrimaryCNS Lymphoma...