Usefulness of MR Imaging for Diseases of the Small Intestine: Comparison with CT

  • Ji-Hoon Kim (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hyun Kwon Ha (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Min Jee Sohn (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Byung Suck Shin (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Young Suk Lee (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Soo Yoon Chung (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Pyo Nyun Kim (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Moon-Gyu Lee (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yong-Ho Auh (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 1999.03.30
  • Accepted : 1999.05.26
  • Published : 2000.03.31

Abstract

Objective: To evaluate the usefulness of MR imaging for diseases of the small intestine, emphasizing a comparison with CT. Materials and Methods: Thirty-four patients who underwent both CT and MR imaging using FLASH 2D and HASTE sequences were analyzed. All patients had various small bowel diseases with variable association of peritoneal lesions. We compared the detectabilities of CT and MR imaging using different MR pulse sequences. The capability for analyzing the characteristics of small intestinal disease was also compared. Results: MR imaging was nearly equal to CT for detecting intraluminal or peritoneal masses, lesions in the bowel and mesentery, and small bowel obstruction, but was definitely inferior for detecting omental lesions. The most successful MR imaging sequence was HASTE for demonstrating bowel wall thickening, coronal FLASH 2D for mesenteric lesions, and axial FLASH 2D for omental lesions. MR imaging yielded greater information than CT in six of 12 inflammatory bowel diseases, while it was equal to CT in six of seven neoplasms and inferior in five of seven mesenteric ischemia. In determining the primary causes of 15 intestinal obstructions, MR imaging was correct in 11 (73%) and CT in nine (60%) patients. Conclusion: MR imaging can serve as an alternative diagnostic tool for patients with suspected inflammatory bowel disease, small intestinal neoplasm or obstruction.

Keywords

References

  1. Chou CK, Chen LT, Sheu RS, Wang ML, Jaw TS, Liu GC. MRI manifestations of gastrointestinal wall thickening. Abdom Imaging 1994;19:389-394  https://doi.org/10.1007/BF00206921
  2. Chou CK, Chen LT, Sheu RS, et al. MRI manifestations of gastrointestinal lymphoma. Abdom Imaging 1994;19:495-500  https://doi.org/10.1007/BF00198248
  3. Ha HK, Lee EH, Lim CH, et al. Application of MRI for small intestinal diseases. J Magn Reson Imaging 1998;8:375-383  https://doi.org/10.1002/jmri.1880080217
  4. Madsen SM, Thomsen HS, Munkholm P, Schlichting P, Davidsen B. Magnetic resonance imaging of Crohn disease: early recognition of treatment response and relapse. Abdom Imaging 1997;22:164-166  https://doi.org/10.1007/s002619900163
  5. Beers BV, Grandin C, Kartheuser A, et al. MRI of complicated anal fistulae: comparison with digital examination. J Comput Assist Tomogr 1994;18:87-90  https://doi.org/10.1097/00004728-199401000-00018
  6. Regan F, Bohlman ME, Khazan R, Rodriguez R, Schultze-Haaakh H. MR urography using HASTE imaging in the assessment of ureteric obstruction. AJR 1996;167:1115-1120  https://doi.org/10.2214/ajr.167.5.8911161
  7. Aerts P, Hoe LV, Bosmans H, Oyen R, Marchal G, Baert AL. Breath-hold MR urography using the HASTE technique. AJR 1996;166:543-545  https://doi.org/10.2214/ajr.166.3.8623625
  8. Miyazaki T, Yamashita Y, Tsuchigame T, Yamamoto H, Urata J, Takahashi M. MR cholangiopancreatography using HASTE (half-Fourier acquisition single-shot turbo spin-echo) sequences. AJR 1996;166:1297-1303  https://doi.org/10.2214/ajr.166.6.8633435
  9. Tang Y, Yamashita Y, Namimoto T, et al. The value of MR urography that uses HASTE sequences to reveal urinary tract disorders. AJR 1996;167:1497-1502  https://doi.org/10.2214/ajr.167.6.8956584
  10. Yamashita Y, Namimoto T, Abe Y, et al. MR imaging of the fetus by a HASTE sequence. AJR 1997;168:513-519  https://doi.org/10.2214/ajr.168.2.9016238
  11. Regan F, Beall DP, Bohlman ME, et al. Fast MR imaging and the detection of small-bowel obstruction. AJR 1998;170:1465-1469  https://doi.org/10.2214/ajr.170.6.9609154
  12. Fukuya T, Hawes DR, Lu CC, Chang PJ, Barloon TJ. CT diagnosis of small-bowel obstruction: efficacy in 60 patients. AJR 1992;158:765-769  https://doi.org/10.2214/ajr.158.4.1546591
  13. Gazelle GS, Goldberg MA, Wittenberg J, Halpern EF, Pinkney L, Mueller PR. Efficacy of CT in distinguishing small-bowel obstruction from other causes of small-bowel dilatation. AJR 1994;162:43-47  https://doi.org/10.2214/ajr.162.1.8273687
  14. Giovagnoni A, Misericordia M, Terilli F, Brunelli E, Contucci S, Bearzi I. MR imaging of ulcerative colitis. Abdom Imaging 1993;18:371-375  https://doi.org/10.1007/BF00201786
  15. Auh YH, Lim T-H, Lee DH, et al. In Vitro MR imaging of the resected stomach with a 4.7-T superconducting magnet. Radiology 1994;191:129-134  https://doi.org/10.1148/radiology.191.1.8134558
  16. Pattern RM, Moss AA, Fenton TA, Elliot S. OMR. A positive bowel contrast agent for abdominal and pelvic MR imaging: safety and imaging characteristics. J Magn Reson Imaging 1992;2:25-34 https://doi.org/10.1002/jmri.1880020105
  17. Patten RM, Lo SK, Philips JJ, et al. Positive bowel contrast agent for MR imaging of the abdomen: phase II and III clinical trials. Radiology 1993;189:277-283  https://doi.org/10.1148/radiology.189.1.8372205
  18. Ros PR, Steinman RM, Torres GM, et al. The value of barium as a gastrointestinal contrast agent in MR imaging: a comparison study in normal volunteers. AJR 1991;157:761-767  https://doi.org/10.2214/ajr.157.4.1892032
  19. Anderson CM, Brown JJ, Balfe DM, et al. MR imaging of Crohn disease: use of perflubron as a gastrointestinal contrast agent. J Magn Reson Imaging 1994;4:491-496  https://doi.org/10.1002/jmri.1880040342
  20. Hiraishi K, Narabayashi IN, Fujita O, et al. Blueberry juice: preliminary evaluation as an oral contrast agent in gastrointestinal MR imaging. Radiology 1995;194:119-123  https://doi.org/10.1148/radiology.194.1.7997537
  21. Low RN, Sigeti JS. MR imaging of peritoneal disease: comparison of contrast-enhanced fast multiplanar spoiled gradient-recalled and spin-echo imaging. AJR 1994;163:1131-1140  https://doi.org/10.2214/ajr.163.5.7976889
  22. Ha HK, Kim JS, Lee MS, et al. Differentiation of simple and strangulated small-bowel obstructions: usefulness of known CT criteria. Radiology 1997;204:507-512  https://doi.org/10.1148/radiology.204.2.9240545