Small-bowel disease: comparison of MR enteroclysis images with conventional enteroclysis and surgical findings.

Abstract

To investigate if magnetic resonance (MR) enteroclysis can be performed routinely and to compare MR enteroclysis findings with those of conventional enteroclysis or surgery. MR enteroclysis was prospectively performed in 30 patients with symptoms of inflammatory bowel disease or small-bowel obstruction (SBO). A methylcellulose-water solution was used to distend the small bowel. To monitor dynamic changes in the small bowel, a single-shot fast spin-echo T2-weighted sequence was applied. For morphologic assessment, breath-hold T2-weighted fast spin-echo and coronal T1-weighted gradient-recalled-echo MR images were obtained without and with gadolinium enhancement. Image quality and degree of small-bowel distention were graded. MR imaging findings and degree of SBO were compared with findings at conventional enteroclysis (n = 25) or surgery (n = 5). MR enteroclysis was well tolerated and provided adequate image quality and sufficient small-bowel distention. SBO grade based on MR enteroclysis images (n = 10) was identical to that based on conventional enteroclysis images (n = 6) or surgical findings (n = 4). There was exact agreement between MR enteroclysis and retrospective findings in all five patients who underwent surgery, and MR findings were identical to those at enteroclysis in 18 patients, superior in six patients, and inferior in one patient. MR enteroclysis can be performed routinely with adequate image quality and sufficient small-bowel distention. The functional information provided by MR enteroclysis is identical to that provided at conventional enteroclysis.