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Published on: October 29, 2014
Use of small bowel MRI enteroclysis in the management of paediatric IBD
1Department of Paediatric Gastroenterology, Hepatology & Nutrition, Addenbrooke's Hospital, Cambridge University, Cambridge, UK.
Insights
MR enteroclysis (MRE) is a well-tolerated and sensitive imaging technique for pediatric inflammatory bowel disease (IBD). This method provides crucial small bowel details, aiding clinicians in making informed treatment decisions for children with IBD.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Inflammatory Bowel Disease
Background:
- Children with inflammatory bowel disease (IBD) often experience small bowel involvement.
- Accurate assessment of the entire small bowel is crucial for effective IBD treatment in pediatric patients.
- Magnetic resonance imaging enteroclysis (MRE) shows promise in adults, but pediatric data is limited.
Purpose of the Study:
- To report the experience of performing MRE in children with IBD.
- To review indications, findings, and the utility of MRE in a pediatric tertiary unit.
- To evaluate the advantages and disadvantages of MRE for pediatric IBD assessment.
Main Methods:
- Retrospective analysis of 34 MRE studies involving 29 pediatric IBD patients.
- Nasojejunal (NJ)-tube placement during endoscopy prior to MRI.
- All patients underwent upper and lower endoscopy under general anesthesia before MRE.
Main Results:
- Common findings included small and large bowel wall thickening, strictures, and enlarged lymph nodes.
- MRE results were pivotal in guiding clinical decisions for all patients, irrespective of findings.
- The technique demonstrated sensitivity in detecting abnormalities in the small bowel.
Conclusions:
- MR enteroclysis is a well-tolerated and sensitive method for pediatric small bowel imaging.
- MRE provides detailed information essential for critical clinical decision-making in pediatric IBD.
- Accurate MRE data enables appropriate and timely clinical management of pediatric IBD patients.
Introduction:
Children with inflammatory bowel disease (IBD) frequently present with small bowel involvement at some stage of their disease. Hence, reliable assessment of the entire small bowel is required in order to adjust treatment accordingly. Recently, magnetic resonance imaging (MRI) of the small bowel in combination with luminal contrast agent delivered via a naso-jejunal tube (MR enteroclysis) is an emerging technique demonstrating good results in adult patients. However, data on its use and benefits in children is limited.
Aims:
In this study we report our experience on performing small bowel MR enteroclysis (MRE) in children with IBD. Specifically, we reviewed indications, MR findings, advantages and disadvantages of the technique in a tertiary unit.
Methods:
A total of 34 MRE studies (29 paediatric IBD patients) were retrospectively analysed. All patients underwent upper and lower endoscopy under general anaesthetic (GA) the day before MR imaging was performed. Nasojejunal (NJ)-tube was placed during endoscopy.
Results:
Frequently detected findings included small and large bowel wall thickening, small bowel strictures and intestinal lymph node enlargement. Importantly, in all our clinical cases, MRE results were key to making a clinical decision in the given scenario regardless of whether MRE findings were positive or negative.
Conclusions:
Within our setup, MR enteroclysis is a well-tolerated, sensitive technique for small bowel imaging, providing detailed information at crucial clinical decision points. Moreover, accurate information then allows appropriate clinical decisions to be made.
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