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MR enterography - Impact on image quality between single- versus split-dose Buscopan
Akshay Rao1, Fariha Sitheeque1, Sonja Gustafson1
1Department of Medical Imaging, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Introduction:
MR enterography (MRE) is the most common imaging modality used to assess small bowel pathology, particularly patients with suspected Crohn's disease. Spasmolytic agents, most commonly Buscopan, are routinely used to reduce or cease movement/bowel activity in order to reduce blurring of the images which would otherwise reduce its diagnostic quality. The purpose of this study was to determine if administering an evenly split dose of Buscopan would improve the quality of images obtained relative to the standard single dose performed at our institution.
Methods:
Cine sequences through the anterior and mid-abdomen were performed to assess and document small bowel peristalsis. Additional analysis was performed by the use of digital subtraction and measuring the signal-to-noise ratio value on the subtracted image, which was used to compare the amount of small bowel movement.
Results:
A total of 34 patients who presented to the Department of Medical Imaging between October 2018 and April 2019 were included. In the anterior section, those in the split-dose group had a mean difference of 2.4 lower number of peristalsing bowel loops compared to the single-dose group (P = 0.001), while in the mid-section, those in the split-dose group had a mean difference of 2.5 lower number of peristalsing bowel loops compared to the single-dose group (P-value = 0.001).
Conclusion:
Our findings indicate that split-dose Buscopan significantly reduced peristalsis compared to single-dose Buscopan, and a reduction in peristalsis reduces one aspect of motion artefact, which translates to better images.
Insights
Split-dose Buscopan significantly reduces bowel peristalsis compared to a single dose, leading to improved image quality in MR enterography for Crohn's disease assessment.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- MR enterography (MRE) is crucial for evaluating small bowel pathology, especially Crohn's disease.
- Spasmolytic agents like Buscopan are used in MRE to minimize motion blur and enhance diagnostic image quality.
- Standard MRE protocols often involve a single dose of Buscopan.
Purpose of the Study:
- To investigate whether an evenly split dose of Buscopan improves MR enterography image quality compared to a standard single dose.
- To quantify the effect of split-dose versus single-dose Buscopan on small bowel peristalsis.
Main Methods:
- Evaluated 34 patients undergoing MR enterography between October 2018 and April 2019.
- Utilized cine sequences to assess small bowel peristalsis in anterior and mid-abdominal sections.
- Employed digital subtraction and signal-to-noise ratio measurements to compare bowel movement between groups.
Main Results:
- The split-dose Buscopan group showed a significantly lower number of peristalsing bowel loops in both anterior (mean difference 2.4, P=0.001) and mid-abdominal sections (mean difference 2.5, P=0.001) compared to the single-dose group.
- This reduction in peristalsis indicates less bowel motion in the split-dose group.
Conclusions:
- Split-dose Buscopan administration significantly reduces small bowel peristalsis compared to a single dose.
- Reduced peristalsis minimizes motion artifacts, thereby enhancing the diagnostic quality of MR enterography images.
- This finding supports the optimization of Buscopan dosing for improved MRE studies.
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