Small bowel MRI: existing and new techniques

Congress:

ECR 2020

Poster Number:

C-06519

Type:

Educational Exhibit

Keywords:

Not applicable, Motility, Imaging sequences, Diagnostic procedure, MR-Enterography, MR-Diffusion/Perfusion, MR, Small bowel, Gastrointestinal tract, GI Tract

Authors:

M. Dedelaite, E. B. Mark, D. Bertoli, J. B. Frøkjær; Aalborg/DK

DOI:

10.26044/ecr2020/C-06519

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-06519

Fig. 1: Mesenteric inflammation (white arrow) and focal thickening of ileum-wall with...

Fig. 2: Thickening of the ileum-wall on coronal T2-TSE image (white arrow).

Fig. 9: Transmural enhancement (white arrow) on coronal T1-FFE image after intravenous...

Learning objectives

To discuss the indications and clinical use for small bowel MRI. To discuss the requirements for small bowel MRI protocol for routine clinical use. To describe the potential use of new MRI techniques for small bowel MRI.

Background

MRI-based techniques are the effective and preferred means to image and evaluate the small bowel. The lack of ionizing radiation makes it preferable to CT, particularly in younger patients who require multiple follow-up scans. Cine-MRI possesses the advantage of assessing small bowel motility, while diffusion-weighted imaging provides functional and quantitative information at the cellular level.

Findings and procedure details

Clinical indications: Diagnosis of the inflammatory bowel disease (IBD): luminal, mural and extra-intestinal diagnostic information. Crohn’s disease (CD) - the most common clinical indication. For ulcerative colitis, MR scanning is a suitable alternative to colonoscopy. Assessment and grading of the CD'sactivity ( Table 1 )( Fig. 1, Fig. 2, Fig. 3, Fig. 4 ). Assessment of complications ( Table 2 )( Fig. 5, Fig. 6, Fig. 7 ). Follow-up of the IBD. Small bowel masses ( Table 3 ). Other small bowel pathologies ( Table...

Conclusion

MRI small bowel protocols using updated techniques are of crucial importance in obtaining sufficient diagnostic images and improving diagnostic sensitivity. New techniques could potentially support a better understanding of different aspects of gastrointestinal pathology, like the quantitative evaluation of small bowel motility could be a powerful biomarker to monitor Crohn’s disease process in a non-invasive way.

Personal information and conflict of interest

M. Dedelaite; Aalborg/DK - nothing to disclose E. B. Mark; Aalborg/DK - nothing to disclose D. Bertoli; Aalborg/DK - nothing to disclose J. B. Frøkjær; Aalborg/DK - nothing to disclose

References

[1] Gourtsoyiannis, NC. (Ed.). (2011). Clinical MRI of the abdomen. Why, how, when. Springer. [2] Masselli G, Gualdi G. MR imaging of the small bowel. Radiology 2012 Aug; 264(2):333-48. PMID: 22821694. [3] Arrive L, El Mouhadi S. MR Enterography versus MR Enteroclysis. Radiology 2013 Feb; 266(2):688. PMID: 23362101. [4] Lu J, Zhou Z, Morelli JN, Yu H, et al. A Systematic Review of Technical Parameters for MR of the Small Bowel in non-IBD Conditions over the Last Ten Years. Sci Rep. 2019 Oct; 9(1):14100. PMID:...