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 25 April 2018

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News

Small bowel follow-through vs magnetic resonance in Crohn's

Magnetic resonance imaging has no radiation and identifies inflammation in strictured areas and colorectal disease, making it an attractive alternative to small bowel follow-through, reports November's American Journal of Gastroetenterology.

News image

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Dr Charles Bernstein and colleagues from Canada compared magnetic resonance imaging with small bowel follow-through to assess Crohn's disease.

Subjects were eligible if they were over 18 years of age undergoing small bowel follow-through investigations.

The subjects were undergoing investigations for complications or extent of Crohn's disease.

Small bowel follow-through was performed by a single radiologist, and within 4 weeks magnetic resonance imaging was performed by a single radiologist.

The radiologist was blinded to the small bowel follow-through results.

For magnetic resonance imaging, oral contrast was 2% barium sulfate at 1,350 mL.

Magnetic resonance imaging gave enhanced information in 8 patients vs 4 with small bowel follow-through
American Journal of Gastroenterology

The research team gave the subjects intravenous glucagon and gadolinium after unenhanced T1 weighted images and single shot fast spin echo T2 imaging.

The team obtained fast multiplanar spoiled-gradient recalled T1 coronal sequences followed by abdominal and pelvic axial images.

Magnetic resonance imaging and small bowel follow-through were compared for extent of disease, and for the presence of complications.

The researchers also assessed the ability of both techniques to identify extraintestinal disease.

Paired studies were undertaken within a mean of 22 days in 30 subjects.

The team found that 10 studies were normal by both modalities and 8 studies showed similar extent of Crohn's disease.

Small bowel follow-through revealed additional information in 4, including a stricture in 1 and ileosigmoid fistulas in 2.

The team noted that magnetic resonance imaging provided enhanced information in 8 patients, vasa recta changes.

Magnetic resonance imaging also identifyied active inflammation in strictured areas based on wall enhancement patterns, and lymphadenopathy.

Dr Bernstein's team concluded, “On the basis of cost and accessibility, small bowel follow-through may still be a first line procedure of choice in some centers without magnetic resonance imaging.”

“However, magnetic resonance imaging's advantages of no radiation and the potential to identify active inflammation in strictured areas, extraintestinal, and colorectal disease make it an attractive alternative.”

Am J Gastroenterol 2005: 100(11): 2493
07 November 2005

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