Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Introduction: Magnetic Resonance Imaging of the Small Bowel (MR Enterography or MRE) is becoming increasingly popular as the first imaging modality for the diagnosis and follow-up of small bowel diseases. The inherent advantages of MRI including excellent soft tissue contrast, multi-planar capability and lack of ionizing radiation are well known. In addition, the use of luminal contrast agents in MRE has the added advantage of demonstrating the lumen and the wall directly, something not possible to achieve with conventional small bowel barium follow-through. Aim: The aim of this work is to evaluate the role of recent MRI sequences and techniques in evaluation of small bowel disease. Patients & Methods: The study population included 24 patients who were referredto multiple radiology centers by gastroenterologist for magnetic resonance enterography (MRE) for evaluation.The examination was done on 1.5 Tesla superconducting magnet MRI machines; Siemens MagnetomAvanto (Erlangen, Germany). Results: All studied patients had small bowel lesions: 15 patients had neoplastic lesions (64%) and 9 patients had non-neoplastic lesions (36%). Among 15 neoplastic lesions, 12 were malignant and 3 were benign. The malignant cases were classified as follows; lymphoma (6 patients); adenocarcinoma (4 patients); GIST (1 patient) and carcinoid tumor (1 patient).Nine patients with non-neoplastic small bowel disease were classified as follows;seven patients had crohn?s disease, one patient had chronic non-specific ileitis and one patient proved pathologically to be TB of small bowel.The final diagnosis was confirmed by endoscopic and pathological data and follow up. Conclusions: MRE is accurate non-invasive modalities in assessing the intra-luminal, parietal and extra-luminal small bowel tumor without the need for ionizing radiation. MR signal appearances of the lesions combined with the contrast enhancement behavior and the characteristic of the stenosis can help in differentiating neoplastic from other non-neoplastic diseases of small bowel. It has great potential in investigating suspected and confirmed crohn?s disease and other suspected small bowel pathologies. MR imaging enhancement patterns may reliably help discriminate between active and inactive crohn?s disease.

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