Citation, DOI, disclosures and article data
At the time the article was created Yuranga Weerakkody had no recorded disclosures.View Yuranga Weerakkody's current disclosures
NB: This article is intended to outline some general principles of protocol design. The specifics will vary depending on MRI hardware and software, radiologist's and referrer's preference, institutional protocols, patient factors (e.g. allergy), and time constraints.
MR enteroclysis, similar to MR enterography, is most commonly used to evaluate patients with Crohn disease where it is used for assessment of the primary disease and any complications. Other indications include celiac disease, postoperative adhesions, radiation enteritis, scleroderma, small bowel malignancies, and polyposis syndromes.
Although enteroclysis has been shown to give a better small bowel distention, there are only a few studies directly comparing this method with MR enterography (per os). The choice for one over the other should follow local or institutional guidelines.
compared to MR enterography
better bowel distention (cf. MRE)
reported as having a superior detection of mild small bowel superficial pathology and jejunal disease 9
compared to CT enterography or enteroclysis
compared to MR and CT enterography
nasoenteric intubation can be an unpleasant procedure for patients
placement of a nasoduodenal tube under fluoroscopic guidance
small bowel distension with 1-3 L of methylcellulose (0.5%) and water solution or isosmotic water solution through an electric infusion pump (located outside the scanner room): infusion rate: 80-200 mL/min 1,8
subsequently, every 5 minutes, depending on the degree of distention observed from the HASTE images, coronal and axial true fast imaging with steady-state precession (FISP) sequences with fat saturation are performed with a slice thickness of 5 mm to study morphologic changes
with maximal distention, multislice HASTE images with fat saturation and unenhanced and enhanced (0.1 mmol/kg gadolinium) T1 coronal and axial fast low-angle shot (FLASH) 2D images with fat saturation are obtained 60 seconds after contrast injection
- 1. Wiarda BM, Kuipers EJ, Heitbrink MA et-al. MR Enteroclysis of inflammatory small-bowel diseases. AJR Am J Roentgenol. 2006;187 (2): 522-31. doi:10.2214/AJR.05.0511 - Pubmed citation
- 2. Prassopoulos P, Papanikolaou N, Grammatikakis J et-al. MR enteroclysis imaging of Crohn disease. Radiographics. 2001;21 Spec No (suppl_1): S161-72. doi:10.1148/radiographics.21.suppl_1.g01oc02s161 - Pubmed citation
- 3. Gourtsoyiannis N, Papanikolaou N, Grammatikakis J et-al. MR enteroclysis protocol optimization: comparison between 3D FLASH with fat saturation after intravenous gadolinium injection and true FISP sequences. Eur Radiol. 2001;11 (6): 908-13. Pubmed citation
- 4. Gourtsoyiannis NC, Papanikolaou N. Magnetic resonance enteroclysis. Semin. Ultrasound CT MR. 2005;26 (4): 237-46. Pubmed citation
- 5. Maglinte DD, Siegelman ES, Kelvin FM. MR enteroclysis: the future of small-bowel imaging?. Radiology. 2000;215 (3): 639-41. doi:10.1148/radiology.215.3.r00jn50639 - Pubmed citation
- 6. Masselli G, Casciani E, Polettini E et-al. Comparison of MR enteroclysis with MR enterography and conventional enteroclysis in patients with Crohn's disease. Eur Radiol. 2008;18 (3): 438-47. doi:10.1007/s00330-007-0763-2 - Pubmed citation
- 8. Van Weyenberg SJ, Meijerink MR, Jacobs MA et-al. MR enteroclysis in refractory celiac disease: proposal and validation of a severity scoring system. Radiology. 2011;259 (1): 151-61. doi:10.1148/radiol.11101808 - Pubmed citation
- 9. S. Cappabianca, V. Granata, G. Di Grezia, Y. Mandato, A. Reginelli, V. Di Mizio, R. Grassi, A. Rotondo. The role of nasoenteric intubation in the MR study of patients with Crohn’s disease: our experience and literature review. (2011) La radiologia medica. 116 (3): 389. doi:10.1007/s11547-010-0605-1 - Pubmed