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The role of nasoenteric intubation in the MR study of patients with Crohn’s disease: our experience and literature review

Il ruolo dell’intubazione naso-enterica nella tecnica di studio RM nei pazienti con morbo di Crohn: nostra esperienza e review della letteratura

  • Abdominal Radiology / Radiologia Addominale
  • Published:
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Abstract

Purpose

The aim of this study was to compare magnetic resonance (MR) enteroclysis with MR enterography to verify whether nasoenteric intubation in patients affected by Crohn’s disease can provide supplementary information to that afforded by MR study of the small bowel.

Materials and methods

In a 12-month period, 40 patients (28 women and 12 men, mean age 35 years) affected by Crohn’s disease underwent MR imaging. Distension of the small-bowel loops was obtained by administering polyethylene glycol: 15 patients were given the mixture by mouth (MR enterography), whereas the remaining 25 received it via nasoenteric intubation (MR enteroclysis). Our study protocol included morphological sequences taken before and after intravenous injection of contrast medium and real-time functional sequences. Accuracy criteria for the execution of the examinations were designed according to 11 bands.

Results

Complete distension of the small-bowel loops was obtained in the 25 patients who underwent MR enteroclysis, with the additional advantage of a suitable assessment of those segments involved in the pathological process. This was not the case for the 15 patients who underwent MR enterography, because both the jejunum and the small-bowel loops appeared partially collapsed.

Conclusions

MR enteroclysis is the most effective technique for studying the small bowel in Crohn’s disease, as it not only provides a suitable morphological assessment but also supplies functional information.

Riassunto

Obiettivo

Lo scopo di questo lavoro è quello di confrontare la resa della risonanza magnetica (RM) con somministrazione di mezzo di contrasto tramite sondino naso-enterico (MR-e) piuttosto che per via orale (MR-os), allo scopo di valutare se l’intubazione naso-enterica nei pazienti con morbo di Crohn fornisca un valore aggiunto alla RM dell’intestino tenue.

Materiali e metodi

In un periodo di 12 mesi, 40 pazienti con morbo di Crohn (28 femmine e 12 maschi; età media 35 anni) sono stati sottoposti ad esame RM. La distensione delle anse dell’intestino tenue è stata ottenuta con polietilen glicole (PEG): 15 pazienti hanno assunto per os la miscela (MR-os), mentre a 25 pazienti è stata iniettata tramite sondino naso-enterico (MR-e). Il protocollo di studio ha incluso sequenze pre- e post-contrastografiche morfologiche e per la MR-e sono state effettuate sequenze funzionali real-time. I criteri di correttezza dell’esecuzione degli esami erano basati sulla valutazione di 11 parametri.

Risultati

Nei 25 pazienti sottoposti ad MR-e si è ottenuta una completa distensione di tutte le anse dell’intestino tenue con un’adeguata valutazione dei tratti interessati dal processo patologico, così non è stato nei 15 sottoposti ad MR-os poiché le anse del digiuno e del tenue prossimale sono risultate parzialmente collabite.

Conclusioni

La MR-e è la tecnica più efficace nello studio dell’intestino tenue nei pazienti affetti da morbo di Crohn, fornendo un’adeguata valutazione morfologica, ma anche informazioni funzionali.

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Authors and Affiliations

  1. Dipartimento di Internistica clinica e sperimentale “Magrassi-Lanzara”, Sezione di Radiodiagnostica e Radioterapia, Seconda Università degli Studi di Napoli, P.zza Miraglia 2, 80138, Napoli, Italy

    S. Cappabianca, V. Granata, G. Di Grezia, Y. Mandato, A. Reginelli, R. Grassi & A. Rotondo

  2. Servizio di Radiologia, Ospedale San Massimo, Penne, Pescara, Italy

    V. Di Mizio

Authors
  1. S. Cappabianca
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  2. V. Granata
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  3. G. Di Grezia
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  4. Y. Mandato
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  5. A. Reginelli
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  6. V. Di Mizio
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  7. R. Grassi
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  8. A. Rotondo
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Correspondence to G. Di Grezia.

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Cappabianca, S., Granata, V., Di Grezia, G. et al. The role of nasoenteric intubation in the MR study of patients with Crohn’s disease: our experience and literature review. Radiol med 116, 389–406 (2011). https://doi.org/10.1007/s11547-010-0605-1

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  • DOI: https://doi.org/10.1007/s11547-010-0605-1

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