Christian Hohl, Presenter: Nothing to Disclose

Melanie Ahaus MD, Abstract Co-Author: Nothing to Disclose

Thorsten Schmidt MD, Abstract Co-Author: Nothing to Disclose

Rolf W. Günther, Abstract Co-Author: Nothing to Disclose

Tobias Wenzl MD, Abstract Co-Author: Nothing to Disclose

Gundula Staatz MD, Abstract Co-Author: Nothing to Disclose

To investigate the value of MR Imaging with a contrast enhanced 2D-balanced-FFE (True-FISP) sequence in comparison to conventional MR-sequences in the evaluation of children with suspected inflammatory bowel disease.

30 children, aged 7-18 years, with suspected inflammatory bowel disease underwent MR-Imaging on a 1.5T-scanner (Philips ACS-NT, Best, Netherlands). 1 hour after 1l of 2.5% mannitol-solution was given orally, MR imaging was performed using coronal HASTE-M2D, coronal fat-suppressed T2-TSE, axial dynamic T1-weighted GE-sequences before and after i.v.-contrast material injection and a 2D-balanced-FFE-sequence (True-FISP) before and after i.v.-contrast material injection in coronal and axial planes. The MR-images were evaluated retrospectively regarding the sensitivity and specificity of each sequence in the detection of intestinal abnormalities as well as the delineation of thickening of the small-bowel wall and the ileocecal valve. The image findings were correlated with the histopathologic findings and when available with conventional x-ray enteroclysis. Furthermore, the image quality was assessed regarding the different tissue-contrasts and the susceptibility to artifacts.

The sensitivity in the detection of small-bowel abnormalities was found to be 97% with use of the True-FISP-sequence and 88-95% with use of the other sequences. The True-FISP sequence revealed the best soft-tissue differentiation in comparison to all other performed MR-sequences. The delineation of the bowel wall thickening, the ileocecal-valve and of extraintestinal inflammatory reaction was significantly improved applying the True-FISP-sequence. The difference between pre- and post i.v.-contrast-enhanced True-FISP-sequences was statistically not significant.

MR Imaging with the use of the True-FISP-sequence is a powerfull tool in the diagnosis and follow up of children with inflammatory bowel disease. Compared to conventional MR-sequences, the True-FISP sequence significantly improves the assessment of inflammatory changes regarding delineation of bowel wall thickening and perintestinal inflammation, so that conventional x-ray investigations can mostly be replaced.

Hohl, C, Ahaus, M, Schmidt, T, Günther, R, Wenzl, T, Staatz, G, MR Imaging of the Small Bowel in Children with Chronic Inflammatory Bowel Disease.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4411537.html