Conventional enteroclysis with complementary MR enteroclysis: a combination of small bowel imaging

Excerpt

In recent years, there have been important improvements in different technologies and procedures to evaluate small bowel diseases. Among these new technologies and procedures: push enteroscopy, capsule endoscopy, magnetic resonance enteroclysis (MRE), and computed tomographic enteroclysis (CTE) have provided competitive and/or complementary modalities compared with classic conventional small bowel through and conventional enteroclysis (CE) examinations [1‐10]. As very well appreciated, all modalities have their own advantages and disadvantages and indications and limitations. Despite these technologic advances, radiologic workup remains the first stage in the diagnosis of small bowel diseases and CE is the gold standard in the evaluation of mucosal pathologies, morphologic changes, and luminal and functional abnormalities [11]. However, in some cases, the effectiveness of CE decreases due to overlapping bowel loops. In addition, pathologic changes may not be limited to the small bowel wall. Although CE provides indirect findings concerning the wall and perienteric structures, complementary imaging is often needed in cases in which the pathologic changes go beyond the small bowel wall. Cross-sectional imaging methods such as computed tomography (CT) and magnetic resonance imaginig (MRI) are not affected by overlapping bowel loops, provide sufficient information about mural pathologies, and determine the extraluminal extension of the disease and surrounding structures. Multidetector-row CT (MDCT) and MRI have become successful alternative cross-sectional imaging modalities for more detailed small bowel examinations [12‐18]. MRI has multiplanar imaging capacity and excellent soft tissue contrast without any radiation exposure. In addition, with improved breath-hold, fast and ultrafast imaging sequences, high performance gradient coils, and dedicated abdominal phased array coils, image quality of gastrointestinal MRI has improved and the timing handicap has been overcome [15‐22]. MDCT shares the same advantages as MRI but radiation poses well-known risks [10, 12‐14, 18]. This report discusses the technique and findings of the combination of CE and MRE in the evaluation of different small bowel diseases. …