Related Experiment Video
Updated: Apr 19, 2026
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Does a cleansing enema improve image quality of 3T surface coil multiparametric prostate MRI?
Christopher Lim1, Jeff Quon1, Matt McInnes1
1Ottawa Hospital, University of Ottawa, Department of Radiology, Civic Campus C1, Ottawa, Ontario, Canada.
Purpose:
To assesses the utility of a preparatory enema in the interpretation of prostate multiparametric (MP) magnetic resonance imaging (MRI).
Materials And Methods:
Under a waiver from the Institutional Review Board (IRB), 32 patients without bowel preparation and 28 patients who underwent a self-administered enema were imaged consecutively with 3T MP-MRI over 6 months. Two blinded radiologists independently assessed image quality on T2 -weighted (T2 W), trace b 1000 mm(2) /sec echo-planar (EPI) and apparent-diffusion coefficient (ADC) and assessed for motion/blur on T2 W and distortion/blur on EPI and ADC. Radiologists also quantified rectal stool and gas. A third blinded radiologist generated contrast curves from dynamic contrast-enhanced (DCE) data at six locations and measured the number of corrupted data points, defined as >10% aberrant signal intensity change. Subjective scores were compared using Wilcoxon sign rank test. Rectal contents were correlated to artifact using Spearman correlation. Contrast curves were evaluated with independent t-tests.
Results:
There was no difference in image quality on T2 W (P = 0.66-0.74), EPI (P = 0.13-0.36) or ADC (P = 0.49-0.59). There was less rectal stool in the enema group (P = 0.004) and amount of stool correlated with motion artifact on T2 W (r = 0.23, P = 0.02); however, there was no difference in motion artifact between groups (P = 0.47-0.94). Only a minority of patients in the non-enema group had moderate or large amounts of stool (16%) and none of these patients had severe or extensive artifact on T2 . There was less rectal gas in the enema group (P = 0.002); however, amount of gas did not correlate with distortion artifact on EPI or ADC (P = 0.17-0.41) and there was no difference in blur (P = 0.41-0.91) or distortion (P = 0.31-0.99) on EPI or ADC between groups. There was no difference in corrupted data points on DCE (P = 0.46).
Conclusion:
In this study the use of a preparatory enema did not improve image quality or reduce artifact in prostate MP-MRI.
Insights
A preparatory enema does not improve image quality or reduce artifacts in prostate multiparametric MRI scans. This study found no significant differences in image interpretation between patients who received an enema and those who did not.
Area of Science:
- Radiology
- Medical Imaging
Background:
- Prostate multiparametric magnetic resonance imaging (MP-MRI) is crucial for diagnosing prostate cancer.
- Image quality in MP-MRI can be affected by rectal contents such as stool and gas.
- The utility of preparatory enemas in improving prostate MP-MRI quality is not well-established.
Purpose of the Study:
- To evaluate the effectiveness of a preparatory enema in enhancing the interpretation of prostate multiparametric MRI.
- To determine if enema use reduces artifacts and improves image quality in prostate MP-MRI.
Main Methods:
- A comparative study involving 60 patients undergoing 3T MP-MRI.
- Patients were divided into two groups: those without bowel preparation and those who received a self-administered enema.
- Image quality, motion/blur, distortion, rectal contents, and dynamic contrast-enhanced (DCE) data were assessed by blinded radiologists.
Main Results:
- No significant differences in image quality were observed between the enema and non-enema groups across T2-weighted, EPI, and ADC sequences.
- While the enema group had less rectal stool and gas, these reductions did not correlate with improved image quality or reduced artifacts.
- No significant difference in corrupted data points in DCE-MRI was found between the groups.
Conclusions:
- The use of a preparatory enema does not offer significant benefits in improving image quality or reducing artifacts for prostate MP-MRI.
- Current findings suggest that routine enema preparation may not be necessary for standard prostate MP-MRI examinations.
Related Concept Videos
01:27Imaging Studies IV: Magnetic Resonance Imaging
01:24Magnetic Resonance Imaging
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:27Imaging Studies III: Computed Tomography
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:24Imaging Studies II: Ultrasonography