Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 11/2007

01-11-2007 | Gastrointestinal

Value of cine MRI for better visualization of the proximal small bowel in normal individuals

Authors: Michael R. Torkzad, Roberto Vargas, Chikako Tanaka, Lennart Blomqvist

Published in: European Radiology | Issue 11/2007

Login to get access

Abstract

While enteroclysis seems to be the most efficacious method in achieving bowel distension, enterographic methods have become widespread due to the unpleasantness of enteroclysis and the radiation involved with positioning the catheter. Cine images in MRI can be done without radiation. Our aim is to see if and how cine MR imaging can improve visualization of bowel loops by capturing them while distended. Ten healthy individuals were asked to drink up to 2,000 ml of an oral solution made locally over a 60-min period. Then they underwent MRI using coronal balanced fast field echo (b-FFE) covering small bowel loops. If the initial exam revealed collapsed bowel loops an additional 50 mg of erythromycine was given intravenously with the subject still in the scanner and then cine imaging was performed. The degree of distension of different segments of the small bowel was measured before and after cine imaging and compared. The distension score was significantly higher after addition of the cine images as well, being only significant for depiction of the duodenum and jejunum. Our preliminary study suggests that cine MRI can give better image depiction of the proximal small bowel in healthy volunteers, perhaps circumventing the need for enteroclysis in some cases. There is a need for validation of these results in patients with small bowel disease.
Literature
1.
Masselli G, Casciani E, Polettini E, Lanciotti S, Bertini L, Gualdi G (2006) Assessment of Crohn’s disease in the small bowel: prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis. Eur Radiol 16(21):2817–2827PubMedCrossRef
2.
Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, Papamastorakis G, Prassopoulos P, Roussomoustakaki M (2004) Assessment of Crohn’s disease activity in the small bowel with MR and conventional enteroclysis: preliminary results. Eur Radiol 14(6):1017–1024, JunPubMedCrossRef
3.
4.
Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, Prassopoulos P (2002) MR enteroclysis: technical considerations and clinical applications. Eur Radiol 12(11):2651–2658, NovPubMed
5.
Maglinte DD, Lappas JC, Chernish SM, Sellink JL (1986) Intubation routes for enteroclysis. Radiology 158(2):553–554, FebPubMed
6.
Maglinte DD (2006) Small bowel imaging–a rapidly changing field and a challenge to radiology. Eur Radiol 16(5):967–971, MayPubMedCrossRef
7.
Rogalla P (2005) CT of the small intestine. Eur Radiol 15(Suppl 4):D142–D148, NovPubMed
8.
Minowa O, Ozaki Y, Kyogoku S, Shindoh N, Sumi Y, Katayama H (1999) MR imaging of the small bowel using water as a contrast agent in a preliminary study with healthy volunteers. AJR Am J Roentgenol 173(3):581–582, SepPubMed
9.
Ochsenkuhn T, Herrmann K, Schoenberg SO, Reiser MF, Goke B, Sackmann M (2004) Crohn disease of the small bowel proximal to the terminal ileum: detection by MR-enteroclysis. Scand J Gastroenterol 39(10):953–960, OctPubMedCrossRef
10.
Patak MA, Froehlich JM, von Weymarn C, Ritz MA, Zollikofer CL, Wentz K (2001) Non-invasive distension of the small bowel for magnetic-resonance imaging. Lancet 358(9286):987–988, Sep 22PubMedCrossRef
11.
Lauenstein TC, Vogt FM, Herborn CU, DeGreiff A, Debatin JF, Holtmann G (2003) Time-resolved three-dimensional MR imaging of gastric emptying modified by IV administration of erythromycin. AJR Am J Roentgenol 180(5):1305–1310, MayPubMed
12.
Davies AR, Bellomo R (2004) Establishment of enteral nutrition: prokinetic agents and small bowel feeding tubes. Curr Opin Crit Care 10(2):156–161, AprPubMedCrossRef
13.
Patole S, Rao S, Doherty D (2005) Erythromycin as a prokinetic agent in preterm neonates: a systematic review. Arch Dis Child Fetal Neonatal Ed 90(4):F301–F306, JulPubMedCrossRef
14.
Romano S, De Lutio E, Rollandi GA, Romano L, Grassi R, Maglinte DD (2005) Multidetector computed tomography enteroclysis (MDCT-E) with neutral enteral and IV contrast enhancement in tumor detection. Eur Radiol 15(6):1178–1183, JunPubMedCrossRef
15.
Borthne AS, Abdelnoor M, Rugtveit J, Perminow G, Reiseter T, Klow NE (2006) Bowel magnetic resonance imaging of pediatric patients with oral mannitol MRI compared to endoscopy and intestinal ultrasound. Eur Radiol 16(8):1870, AugCrossRef
16.
Singer AJ, Richman PB, Kowalska A, Thode HC Jr (1999) Comparison of patient and practitioner assessments of pain from commonly performed emergency department procedures. Ann Emerg Med 33(6):652–658, JunPubMed
17.
Carroll K (1998) Crohn’s disease: new imaging techniques. Baillieres Clin Gastroenterol 12(1):35–72, MarPubMedCrossRef
18.
Rieber A, Nussle K, Reinshagen M, Brambs HJ, Gabelmann A (2002) MRI of the abdomen with positive oral contrast agents for the diagnosis of inflammatory small bowel disease. Abdom Imaging 27(4):394–399, Jul–AugPubMedCrossRef
19.
Bernstein CN, Boult IF, Greenberg HM, van der Putten W, Duffy G, Grahame GR (1997) A prospective randomized comparison between small bowel enteroclysis and small bowel follow-through in Crohn’s disease. Gastroenterology 113(2):390–398, AugPubMedCrossRef
20.
Schmidt S, Felley C, Meuwly JY, Schnyder P, Denys A (2006) CT enteroclysis: technique and clinical applications. Eur Radiol 16(3):648–660, MarPubMedCrossRef
21.
Reittner P, Goritschnig T, Petritsch W, Doerfler O, Preidler KW, Hinterleitner T, Szolar DH (2002) Multiplanar spiral CT enterography in patients with Crohn’s disease using a negative oral contrast material: initial results of a noninvasive imaging approach. Eur Radiol 12(9):2253–2257, SepPubMed
22.
Potthast S, Rieber A, Von Tirpitz C, Wruk D, Adler G, Brambs HJ (2002) Ultrasound and magnetic resonance imaging in Crohn’s disease: a comparison. Eur Radiol 12(6):1416–1422, JunPubMedCrossRef
23.
Gourtsoyiannis NC, Grammatikakis J, Papamastorakis G, Koutroumbakis J, Prassopoulos P, Rousomoustakaki M, Papanikolaou N (2006) Imaging of small intestinal Crohn’s disease: comparison between MR enteroclysis and conventional enteroclysis. Eur Radiol 16(9):1915–1925, SepPubMedCrossRef
24.
Minordi LM, Vecchioli A, Guidi L, Mirk P, Fiorentini L, Bonomo L (2006) Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease. Eur Radiol 16(7):1527–1536, JulPubMedCrossRef
25.
Schmidt S, Lepori D, Meuwly JY, Duvoisin B, Meuli R, Michetti P, Felley C, Schnyder P, van Melle G, Denys A (2003) Prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis: interobserver agreement and sensitivity by means of “sign-by-sign” correlation. Eur Radiol 13(6):1303–1311, JunPubMed
26.
Prassopoulos P, Papanikolaou N, Grammatikakis J, Rousomoustakaki M, Maris T, Gourtsoyiannis N (2001) MR enteroclysis imaging of Crohn disease. Radiographics 21 Spec No:S161–S172, OctPubMed
27.
Kuehle CA, Ajaj W, Ladd SC, Massing S, Barkhausen J, Lauenstein TC (2006) Hydro-MRI of the small bowel: effect of contrast volume, timing of contrast administration, and data acquisition on bowel distention. AJR Am J Roentgenol 187(4):W375–W385, OctPubMedCrossRef
28.
Giovagnoni A, Fabbri A, Maccioni F (2002) Oral contrast agents in MRI of the gastrointestinal tract. Abdom Imaging 27:367–375, Jul–AugPubMedCrossRef
29.
Ajaj W, Goyen M, Schneemann H, Kuehle C, Nuefer M, Ruehm SG, Goehde SC, Lauenstein TC (2005) Oral contrast agents for small bowel distension in MRI: influence of the osmolarity for small bowel distention. Eur Radiol 15(7):1400–1406, JulPubMedCrossRef
30.
Borthne AS, Abdelnoor M, Hellund JC, Geitung JT, Storaas T, Gjesdal KI, Klow NE (2005) MR imaging of the small bowel with increasing concentrations of an oral osmotic agent. Eur Radiol 15(4):666–671, AprPubMedCrossRef
31.
Ajaj W, Goehde SC, Schneemann H, Ruehm SG, Debatin JF, Lauenstein TC (2004) Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension. Eur Radiol 14(3):458–464, MarPubMedCrossRef
32.
Schmidt S, Chevallier P, Chalaron M, Bessoud B, Verdun FR, Frascarolo P, Schnyder P, Denys A (2005) Multidetector CT enteroclysis: comparison of the reading performance for axial and coronal views. Eur Radiol 15(2):238–246, FebPubMedCrossRef
33.
Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, maris T, Prassopoulos P. MR imaging of the small bowel with a true-FISP sequence after enteroclyis with water solution. Investigative radiology 35(12):707–711
34.
Maccioni F, Bruni A, Viscido A, Colaiacomo MC, Cocco A, Montesani C, Caprilli R, Marini M (2006) MR imaging in patients with Crohn disease: value of T2- versus T1-weighted gadolinium-enhanced MR sequences with use of an oral superparamagnetic contrast agent. Radiology 238(2):517–530, FebPubMedCrossRef
35.
Low RN, Sebrechts CP, Politoske DA, Bennett MA, Flores S, Snyder RJ, Pressman JH (2002) Crohn Disease with Endoscopic Correlation: Single-Shot Fast Spin-Echo and Gadolinium-enhanced Fat-suppressed Spoiled Gradient-Echo MR Imaging. Radiology 222(3):652–660.PubMedCrossRef
36.
Maccioni F, Bruni A, Viscido A, Colaiacomo MC, Cocco A, Montesani C, Caprilli R, Marini M (2006) MR imaging in patients with Crohn disease: value of T2- versus T1-weighted gadolinium-enhanced MR sequences with use of an oral superparamagnetic contrast agent. Radiology 238(2):517–530, FebPubMedCrossRef
37.
Smith AJ, Nissan A, Lanouette NM, Shi W, Guillem JG, Wong WD, Thaler H, Cohen AM (2000) Prokinetic effect of erythromycin after colorectal surgery: randomized, placebo-controlled, double-blind study. Dis Colon Rectum 43(3):333–337, MarPubMedCrossRef
38.
Frossard JL, Spahr L, Queneau PE, Giostra E, Burckhardt B, Ory G, De Saussure P, Armenian B, De Peyer R, Hadengue A (2002) Erythromycin intravenous bolus infusion in acute upper gastrointestinal bleeding: a randomized, controlled, double-blind trial. Gastroenterology 123(1):17–23, JulPubMedCrossRef
39.
Hawkyard CV, Koerner RJ. The use of erythromycin as a gastrointestintal agent in adult critical care: benefit versus risks
Metadata
Title
Value of cine MRI for better visualization of the proximal small bowel in normal individuals
Authors
Michael R. Torkzad
Roberto Vargas
Chikako Tanaka
Lennart Blomqvist
Publication date
01-11-2007
Publisher
Springer-Verlag
Published in
European Radiology / Issue 11/2007
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-007-0721-z

Other articles of this Issue 11/2007

European Radiology 11/2007 Go to the issue

Pediatric

Optical tomography of the neonatal brain

Erratum

Enhancement patterns and signal-intensity characteristics of small hepatocellular carcinoma in cirrhosis: pathologic basis and diagnostic challenges

Cardiac

Accuracy of contrast-enhanced cine-MR sequences in the assessment of left ventricular function: comparison with precontrast cine-MR sequences. Results of a bicentric study

Interpretation Corner

Multiple intramuscular masses (2007: 11a)

Magnetic Resonance

Perspectives for preventive screening with total body MRI

Experimental

Sixty-four-slice CT in the assessment of global and regional left ventricular function: Comparison with MRI in a porcine model of acute and subacute myocardial infarction