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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2013; 23(01): 86-91
DOI: 10.4103/0971-3026.113623
ORIGINAL ARTICLE

MRI enterography with divided dose oral preparation: Effect on bowel distension and diagnostic quality

Rakesh Sinha
Department of Radiology, GI Unit, South Warwickshire NHS Trust and Warwick Medical School, Lakin Road, Warwick CV34 5BW, England
,
Sudarshan Rawat
Department of Radiology, Ruby Hall Clinic, Pune, India
› Author Affiliations Source of Support: Nill.
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Abstract

Aim: To assess the impact of an extended oral preparation magnetic resonance (MR) enterography protocol on bowel distension, timing of imaging, and the quality of diagnostic images. Materials and Methods: An analysis of 52 patients who underwent divided oral preparation and 39 patients who underwent standard preparation for MR enterography examination was done. Distension was assessed by measuring the transverse diameters of the jejunum, ileum, and the ileocecal region. Diagnostic quality of the examination was assessed subjectively by two radiologists and graded as poor, diagnostic, and excellent (Grades 1-3). Correlation between bowel diameter and diagnostic quality was assessed using regression analysis. Results: The mean diameters of the jejunum, ileum, and colon in patients who underwent divided preparation were 1.90 ± 0.47, 2.14 ± 0.41, and 4.27 ± 0.96 cm, respectively, and the mean diameters in patients who underwent standard preparation were 1.46 ± 0.47, 2.02 ± 0.47, and 4.45 ± 0.90 cm, respectively. A total of 96.6% of patients on divided dose had diagnostic distension of the bowel (Grades 2 and 3). A total of 87.9% of the patients on standard dose had diagnostic distension of the bowel (Grades 2 and 3). A greater number of patients who underwent divided preparation had diagnostic quality examinations compared to those given standard preparation (96.6% vs. 87.9%). A greater number of patients who underwent divided preparation had Grade 3 quality examinations compared to those on standard preparation (75.5% vs. 68.5%). There was significant difference between diagnostic (Grades 2 and 3) and optimal grades (Grade 3) of the jejunal diameters in patients having divided or standard preparation (89.7% vs. 66.6%, P < 0.05; 40.8% vs. 25%, P < 0.05, respectively). Linear regression showed a positive correlation between increasing bowel diameter and diagnostic grade of the examination (ρ = 0.76). Conclusion: Using an extended oral preparation with divided dose resulted in the majority of patients being scanned in a single visit to the MRI suite. Dividing the oral contrast into aliquots can promote uniform distension of the entire small bowel and provide better bowel distension and improve the diagnostic quality.

Keywords

Enterography - MRI - small intestine


Publication History

Article published online:
04 October 2021

© 2013. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Sinha R, Verma R, Verma S, Rajesh A. MR enterography of Crohn disease: Part 1, rationale, technique, and pitfalls. AJR Am J Roentgenol 2011;197:76-9.
  • 2 Sinha R. Recent advances in intestinal imaging. Indian J Radiol Imaging 2011;21:170-5.
  • 3 Schreyer AG, Scheibl K, Heiss P, Feuerbach S, Seitz J, Herfarth H. MR colonography in inflammatory bowel disease. Abdom Imaging 2006;31:302-7.
  • 4 Negaard A, Paulsen V, Sandvik L, Berstad AE, Borthne A, Try K, et al. A prospective randomized comparison between two MRI studies of the small bowel in Crohn′s disease, the oral contrast method and MR enteroclysis. Eur Radiol 2007;17:2294-301.
  • 5 Kuehle CA, Ajaj W, Ladd SC, Massing S, Barkhausen J, Lauenstein TC. Hydro-MRI of the small bowel: Effect of contrast volume, timing of contrast administration, and data acquisition on bowel distention. AJR Am J Roentgenol 2006;187:375-5.
  • 6 Laghi A, Paolantonio P, Catalano C, Dito L, Carbone I, Barbato M, et al. MR imaging of the small bowel using polyethylene glycol solution as an oral contrast agent in adults and children with celiac disease: Preliminary observations. AJR Am J Roentgenol 2003;180:191-4.
  • 7 Sinha R, Murphy P, Hawker P, Sanders S, Rajesh A, Verma R. Role of MRI in Crohn′s disease. Clin Radiol 2009;64:341-52.
  • 8 Sinha R, Rajiah P, Murphy P, Hawker P, Sanders S. Utility of high-resolution MR imaging in demonstrating transmural pathologic changes in Crohn disease. Radiographics 2009;29:1847-67.
  • 9 Lohan D, Cronin C, Meehan C, Alhajeri AN, Roche C, Murphy J. MR small bowel enterography: Optimization of imaging timing. Clin Radiol 2007; 62: 804-7
  • 10 Richard DG, Stevenson GW. Laxatives prior to small bowel follow through: Are they necessary for a rapid good-quality examination? Gastrointest Radiol 1990;15:66.