Advertisement

European Radiology

, Volume 16, Issue 9, pp 1915–1925 | Cite as

Imaging of small intestinal Crohn’s disease: comparison between MR enteroclysis and conventional enteroclysis

  • Nicholas C. Gourtsoyiannis
  • John Grammatikakis
  • George Papamastorakis
  • John Koutroumbakis
  • Panos Prassopoulos
  • Maria Rousomoustakaki
  • Nickolas PapanikolaouEmail author
Gastrointestinal

Abstract

The purpose of this study was to compare MR enteroclysis (MRE) with conventional enteroclysis (CE) in patients with small intestinal Crohn’s disease. Fifty-two consecutive patients with known or suspected Crohn’s disease underwent MR and conventional enteroclysis, which was considered the gold standard. Eleven imaging features, classified in three groups, mucosal, transmural and extraintestinal, were subjectively evaluated by two experienced radiologists. MRE and CE were in full agreement in revealing, localizing and estimating the length of all involved segments of the small bowel. The sensitivity of MRE for the detection of superficial ulcers, fold distortion and fold thickening was 40, 30 and 62.5%, respectively. The sensitivity of MRE for the detection of deep ulcers, cobble-stoning pattern, stenosis and prestenostic dilatation was 89.5, 92.3, 100 and 100%, respectively. Additional findings demonstrated on MRE images included fibrofatty proliferation in 15 cases and mesenteric lymphadenopathy in 19 cases. MRE strongly correlates with CE in the detection of individual lesions expressing small intestinal Crohn’s disease. It provides additional information from the mesenteries; however, its capability to detect subtle lesions is still inferior to conventional enteroclysis.

Keywords

Crohn’s Comparative studies–MR enteroclysis Conventional enteroclysis 

References

  1. 1.
    Nolan DJ, Gourtsoyiannis NC (1980) Crohn’s disease of the small intestine: a review of the radiological appearances in 100 consecutive patients examined by a barium infusion technique. Clin Radiol 31(5):597–603PubMedCrossRefGoogle Scholar
  2. 2.
    Ruiz-Cruces R, Ruiz F, Perez-Martinez M, Lopez J, Tort Ausina I, de los Rios AD (2000) Patient dose from barium procedures. Br J Radiol 73(871):752–761PubMedGoogle Scholar
  3. 3.
    Umschaden HW, Szolar D, Gasser J, Umschaden M, Haselbach H (2000) Small-bowel disease: comparison of MR enteroclysis images with conventional enteroclysis and surgical findings. Radiology 215:717–725PubMedGoogle Scholar
  4. 4.
    Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, Maris T, Prassopoulos P (2000) Magnetic resonance imaging of the small bowel using a True-FISP sequence after enteroclysis with water solution. Invest Radiol 35(12):707–711PubMedCrossRefGoogle Scholar
  5. 5.
    Gourtsoyiannis NC, Papanikolaou N, Grammatikakis J, Maris T, Prassopoulos P (2001) MR enteroclysis protocol optimization: comparison between 3d FLASH with fat saturation after intravenous gadolinium injection and true FISP sequences. Eur Radiol 11(6):908–913PubMedCrossRefGoogle Scholar
  6. 6.
    Prassopoulos P, Papanikolaou N, Grammatikakis J, Rousomoustakaki M, Maris T, Gourtsoyiannis N (2001) MR enteroclysis imaging of crohn disease. Radiographics 21:161–172Google Scholar
  7. 7.
    Rofsky NM, Lee VS, Laub G, Pollack MA, Krinsky GA, Thomasson D, Ambrosino MM, Weinreb JC (1999) Abdominal MR imaging with a volumetric interpolated breath-hold examination. Radiology 212(3):876–884PubMedGoogle Scholar
  8. 8.
    Narin B, Ajaj W, Gohde S et al (2004) Combined small and large bowel MR imaging in patients with Crohn’s disease: a feasibility study. Eur Radiol 14:1535–1542PubMedCrossRefGoogle Scholar
  9. 9.
    Lauenstein TC, Schneemann H, Vogt FM, Herborn CU, Ruhm SG, Debatin JF (2003) Optimization of oral contrast agents for MR imaging of the small bowel. Radiology 228:279–283PubMedCrossRefGoogle Scholar
  10. 10.
    Gourtsoyiannis N, Papanikolaou N, Rieber A, et al (2002) Evaluation of the small intestine by MR imaging. In: Gourtsoyiannis N (ed) Radiological imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 157–170Google Scholar
  11. 11.
    Schunk K, Kern A, Oberholzer K, Kalden P, Mayer I, Orth T, Wanitschke R (2000) Hydro-MRI in Crohn’s disease. Appraisal of disease activity. Invest Radiol 35:431–437PubMedCrossRefGoogle Scholar
  12. 12.
    Maccioni F, Viscido A, Broglia L, Marrollo M, Masciangelo R, Caprilli R, Rossi P (2000) Evaluation of Crohn’s disease activity with magnetic resonance imaging. Abdom Imaging 25:219–228PubMedCrossRefGoogle Scholar
  13. 13.
    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):1017–1024PubMedCrossRefGoogle Scholar
  14. 14.
    Low RN, Sebrechts CP, Politoske DA, Bennett MT, Flores S, Snyder RJ, Pressman JH (2002) Crohn disease with endoscopic correlation: single-shot fast spin echo and gadolinium-enhanced fat-supressed spoiled gradient echo MR imaging. Radiology 222:652–660PubMedCrossRefGoogle Scholar
  15. 15.
    Koh DM, Miao Y, Chinn RJ et al (2001) MR Imaging evaluation of the activity in Crohn’s disease. AJR 177:1325–1332PubMedGoogle Scholar
  16. 16.
    Semelka RC, Chung JJ, Hussain SM, Marcos HB, Woosley JT (2001) Chronic hepatitis: correlation of early patchy and late linear enhancement patterns on gadolinium-enhanced MR images with histopathology initial experience. J Magn Reson Imaging 13(3):385–391PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Nicholas C. Gourtsoyiannis
    • 1
  • John Grammatikakis
    • 1
  • George Papamastorakis
    • 1
  • John Koutroumbakis
    • 2
  • Panos Prassopoulos
    • 3
  • Maria Rousomoustakaki
    • 2
  • Nickolas Papanikolaou
    • 1
    Email author
  1. 1.Department of Radiology, University of Crete Faculty of MedicineUniversity Hospital of HeraklionHeraklionGreece
  2. 2.Department of Gastroenterology, University Hospital of HeraklionUniversity of CreteHeraklionGreece
  3. 3.Department of Radiology, University Hospital of AlexandroupoliUniversity of ThraceAlexandroupoliGreece

Personalised recommendations