Amelia Wnorowski MD, Presenter: Nothing to Disclose

Flavius F. Guglielmo MD, Abstract Co-Author: Nothing to Disclose

Donald G. Mitchell MD, Abstract Co-Author: Consultant, CMC Contrast AB

1. MR enterography (MRE) can be successfully performed and interpreted without the use of antiperistaltic agents. Advantages to this approach include lower cost, less side effects and less interruption in workflow in some instances. 2. The main limitation of MRE without antiperistaltic agents is degraded image quality due to motion artifact. This limitation can be reduced by properly selecting cases and by using a multi-parametric approach when interpreting studies, including evaluating small bowel peristalsis for abnormal decreased motility. 

Background 1. Limitations of antiperistaltic agents 2. Motion artifact from bowel peristalsis when not using antiperistaltics a. Which pulse sequences have the most motion artifact and which have the least 3. Proper interpretation requires a multi-parametric approach a. Using multiple pulse sequences to make the diagnosis b. Peristalsis evaluation 4. Review of MRE indications that do not require antiperistaltics: inflammatory bowel disease, small bowel obstruction, celiac disease, and known small bowel or mesenteric masses MRE Protocol without using antiperistaltics Cine MRE pulse sequence 1. How to perform and interpret a cine balanced steady-state free precession pulse sequence Sample cases with cine clips

http://abstract.rsna.org/uploads/2014/14003745/14003745_dqp3.pdf

Wnorowski, A, Guglielmo, F, Mitchell, D, How to Perform and Interpret MR Enterography Studies without Antiperistaltic Agents, including Peristalsis Evaluation.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003745.html