Techniques for magnetic resonance imaging of the bowel

Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications

High soft tissue contrast resolution, acquisition of multi-planar images and the possibility to obtain functional information make magnetic resonance an interesting imaging technique to evaluate the small bowel disease. The absence of ionizing radiation is an important feature of magnetic resonance imaging (MRI) examinations because inflammatory diseases such as Crohn’s disease (CD) are studied most frequently, which are prevalent among children and young adults. MRI, using modern equipment and a rigorous technical approach, can offer detailed morphologic information and functional data on the small bowel. This article discusses the MRI protocols for small bowel and the MR imaging findings of small bowel diseases, such as CD and small bowel neoplasms.

Small bowel motility assessment with magnetic resonance imaging

PURPOSE

To assess primarily the feasibility of magnetic resonance imaging (MRI) as a tool to monitor small bowel peristaltic motion and secondarily to validate this technique by demonstrating drug-induced motility changes.

MATERIALS AND METHODS

After a standardized oral preparation of Ispaghula husk (Metamucil) and meglumine gadoterate (Gd-DOTA; Dotarem), 10 volunteers underwent dynamic MRI using a two-dimensional turbofast field echo (TFE) sequence with a slice repetition time of 500 msec. Intraluminal cross-sectional caliber changes over time were assessed allowing quantification of the peristaltic frequencies and amplitudes of the small gut on various regions of interest. Pharmacologically induced alterations of the peristaltic motion after spasmolytics and gastrokinetic motion enhancers were investigated.

RESULTS

Small bowel diameter measurement resulted in a peristalsis of 10.96 (SD = +/-2.51) waves per minute, oscillating regularly with mean amplitudes of 6.65 mm (SD = +/-1.15 mm). Peristaltic frequency in normal individuals is consistent with that observed with other techniques. Intravenous administration of scopolamine butylbromide (= hyoscine butylbromide/Buscopan) resulted in small bowel paralysis within 21.3 seconds (SD = +/-2.8 seconds). Prokinetic effect of intravenous metoclopramide (Paspertin) after Buscopan paralysis was tested in one volunteer, characterized by a slow recovery of peristalsis, which propagated from the proximal to the distal segments and enhanced contraction amplitudes.

CONCLUSION

Dynamic MRI allows observing and quantifying small bowel peristalsis, characterizing motion patterns, and monitoring the effects of interfering factors such as drugs.