To outline the imaging modalities available in the investigation of small bowel disease and the relative advantages and disadvantages in their use. To describe the technique of Magnetic Resonance Enteroclysis (MRE). To illustrate MRE imaging findings in a range of small bowel pathology including inflammatory bowel disease.

The radiologic assessment of the small bowel has been compared to separating out and identifying a large number of writhing snakes in a crowded reptile tank at the zoo [1]. Assisting the clinician in this Herculean task is an array of imaging modalities and techniques each with their own set of advantages and limitations and each with varying levels of sensitivity and specificity (Table 1). Modality Advantages Disadvantages Barium follow-through Spatial resolution Radiation dose Poor assessment of extra-luminal disease Small bowel enteroclysis Spatial resolution Detects...

Technique of MR Enteroclysis Imaging protocols and technique may vary due to differences in available equipment, time constraints and personal preference. A 1.5 T Siemens MRI scanner with a 12-channel, phased array torso receiver coil is used at our institution. Naso-jejunal intubation Under fluoroscopic guidance a naso-jejunal catheter is placed in an optimal position just beyond the duodenal-jejunal flexure in order to decrease the chance of luminal contrast refluxing back into the stomach (Fig. 1). The patient is offered sedation and analgesia to minimize discomfort...

Magnetic resonance imaging has now become one of the most frequently used imaging modalities available in the investigation of known or suspected small bowel pathology. It is lack of ionizing radiation is especially useful in the follow-up of young patients with chronic pathology including Crohn’s disease and polyposis syndromes. MR enteroclysis is an excellent imaging test for the investigation of the small bowel. Its optimal bowel distention, superior tissue contrast and dynamic capability can provide vital diagnostic information when imaging the small bowel.

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