Magnetic Resonance Imaging in Gastroenterology: Time to Say Good-bye to All That Endoscopy?

He, Anbang; Breer, H; Karschkes, T; Albert, JG; Jf, Riemann

doi:10.1055/s-2000-639

Cited by 36 publications

(18 citation statements)

References 7 publications

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“…Based upon the physical properties, such as lack of radiation, multiplanar capabilities, multiple anatomical and functional image contrasts that can be generated, magnetic resonance imaging (MRI) is a straightforward alternative for crosssectional imaging of the pediatric gastro-intestinal tract (7)(8)(9)(10).…”

Section: Methodsmentioning

confidence: 99%

Feasibility of an optimized MR enterography protocol in the evaluation of pediatric inflammatory bowel disease

Bosemani¹,

Öztürk²,

Tekes³

et al. 2013

Journal of the Belgian Society of Radiology

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1 cross-sectional imaging forms an important alternative and complimentary tool to endoscopy in aiding the clinician with diagnosis and management of pediatric inflammatory bowel disease (ibd). the purpose of the study was to evaluate the feasibility of an optimized Magnetic Resonance enterography (MRe) protocol in the evaluation of patients with suspected ibd. 31 children (18 boys and 13 girls) were evaluated by a pediatric gastroenterologist prior to MRe and given a grading for clinical severity of disease. imaging was then performed with oral contrast and a tailored protocol using fast t1/t2 weighted pulse sequences. additionally, contrast and glucagon were administered intravenously. imaging findings were then correlated with the clinical data. excellent distension was achieved in the small bowel. the majority of the studies were of diagnostic quality with no motion artifacts. imaging findings showed statistically significant correlation with disease activity. an optimized pediatric MRe protocol is feasible and correlates well with clinical disease activity. this in turn aids the clinician in the management of children with this chronic debilitating disease.

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Section: Methodsmentioning

confidence: 99%

Feasibility of an optimized MR enterography protocol in the evaluation of pediatric inflammatory bowel disease

Bosemani¹,

Öztürk²,

Tekes³

et al. 2013

Journal of the Belgian Society of Radiology

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“…To avoid such disadvantages, MRI has been performed by many researchers using oral contrast media. Many contrast media have been proposed, but no oral contrast medium has yet been accepted universally as optimal for use [2,3,7,[14][15][16][17][18][19][22][23][24][25][26] .…”

Section: Imaging Findingsmentioning

confidence: 99%

“…The absence of ionizing radiation is an important feature of MRI examinations because inflammatory diseases such as Crohn's disease (CD) are studied most frequently, which are prevalent among children and young adults [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications

Zhu¹,

Xu²,

Gong³

et al. 2008

WJG

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High soft tissue contrast resolution, acquisition of multi-planar images and the possibility to obtain functional information make magnetic resonance an interesting imaging technique to evaluate the small bowel disease. The absence of ionizing radiation is an important feature of magnetic resonance imaging (MRI) examinations because inflammatory diseases such as Crohn's disease (CD) are studied most frequently, which are prevalent among children and young adults. MRI, using modern equipment and a rigorous technical approach, can offer detailed morphologic information and functional data on the small bowel. This article discusses the MRI protocols for small bowel and the MR imaging findings of small bowel diseases, such as CD and small bowel neoplasms. There are two main approaches for MRI of the small bowel: (1) study following oral administration of contrast material; and (2) study with distension of lumen obtained with contrast material that is introduced through a naso-jejunal tube (MR enteroclysis). Oral contrast agents for small bowel MRIOral contrast agents can be classified into positive, negative and biphasic categories according to their action on the signal intensity of bowel lumen.A positive agent is a paramagnetic substance that produces a high signal intensity on T1-weighted sequences. It reduces T1 relaxation time without, or only minimally, influencing T2 relaxation time. Because of the water content of the contrast solution, it also results in high signal intensity on T2-weighted images. Positive contrast agents include paramagnetic substances, such as gadolinium chelates, ferrous and manganic ions and manganese ions [12][13][14][15][16] . The use of positive oral contrast agents has been abandoned almost completely because a hyperintense lumen does not enable a clear differentiation with inflammatory parietal enhancement.A negative agent is a substance that produces a low signal intensity on T1-and T2-weighted sequences. These substances induce local inhomogeneity in the magnetic field that affects T1 and T2 relaxation time. T2 effects predominate and are caused by spin dephasing with a consequent loss of signal intensity. Negative contrast agents include perfluorooctyl bromide [17] , iron oxides [15,18] , and oral magnetic particles [14,15] . Barium sulfate, if used at high concentrations, can be considered a negative contrast agent [19] . Negative contrast agents are more favorable if hyperintense signal of the bowel wall and the surrounding fat tissue signs of acute inflammation have to be detected on T2-weighted sequences [15] . However, magnetic susceptibility on gradient echo sequences may alter image quality on breath-held T1-weighted images.The term "biphasic" recently was introduced to define those substances that show different signal intensities depending on different sequences [20] . The first group (hyperintense signal on T1-weighted images and hypointense signal on T2-weighted images) included manganese and substances that contain manganese, and gadolinium chelates, w...

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“…1 These 3D data can be used with MR virtual endoscopy (MRVE) with volume rendering to visualize the lumina of the gallbladder, bile duct, and pancreatic duct. [2][3][4][5][6][7][8][9] In MRVE, it is important to determine the optimum threshold for actual observation of the lumina of the structures of interest. Under suboptimal threshold settings, the internal aspect is disturbed and visualized inappropriately.…”

Section: Introductionmentioning

confidence: 99%

MR Virtual Endoscopy for Biliary Tract and Pancreatic Duct

Azuma

Yamaguchi

Iida

et al. 2007

MRMS

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Developments in magnetic resonance (MR) equipment and techniques have been remarkable. Especially, respiratory-triggered three-dimensional MR cholangiopancreatography (3D-MRCP) has been developed to provide images with high spatial resolution of the biliary tract and pancreatic duct. These 3D data can be employed in MR virtual endoscopy (MRVE) with volume rendering to visualize the lumina of the gallbladder, bile duct, and pancreatic duct. To observe the changes in the lumina with threshold settings on a workstation, we made an original phantom with tubes 2, 3, and 6 mm in internal diameter. We examined the changes in luminal diameter using several threshold settings by comparing the actual internal diameters to determine an appropriate threshold setting, which we then applied in 50 clinical cases, including pancreatic tumors, hepatic tumors, and biliary tract stones. We obtained MRVE images of the gallbladder, bile duct, and pancreatic duct to assess the clinical usefulness of this method. In the phantom study, a value identical to the actual luminal diameter could be obtained with a threshold of less than 20z. In all clinical cases, we obtained MRVE images of the gallbladder, bile duct, and pancreatic duct using the threshold we had determined appropriate and scored the diagnostic usefulness in each region. The MRVE images of the biliary tract provided much supplementary information, including the presence of stones and of duct invasion by the malignancy as wells as visualization of the post-stenotic portion. MRVE images of the gall bladder did not signiˆcantly improve diagnosis (P＝0.311), but those of the bile and pancreatic ducts did (Pº0.05). In addition, MRVE may aid navigation during cholangioscopy. Thus, MRVE is a clinically useful technique for examining lesions of the biliary tract and pancreas.

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Magnetic Resonance Imaging in Gastroenterology: Time to Say Good-bye to All That Endoscopy?

Cited by 36 publications

References 7 publications

Feasibility of an optimized MR enterography protocol in the evaluation of pediatric inflammatory bowel disease

Feasibility of an optimized MR enterography protocol in the evaluation of pediatric inflammatory bowel disease

Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications

MR Virtual Endoscopy for Biliary Tract and Pancreatic Duct

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