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Feasibility of Abdominal Magnetic Resonance Imaging in Patients With Residual Concentrated Enteric Contrast After
1From the Department of Radiology, NYU Langone Medical Center, New York, NY.
Objective:
This study aimed to evaluate the image quality, image artifacts, radiologist confidence, and ability to provide definitive diagnosis for all patients with magnetic resonance imaging (MRI) performed after an abdominal fluoroscopic examination and to determine the utility of MRI in this setting.
Methods:
Thirty-one MRI examinations performed a median of 2 days after fluoroscopic bowel evaluation (barium, n = 13; iodine, n = 18), 20 within 3 days of MRI, were retrospectively reviewed. The image quality, artifact emanating from bowel, inhomogeneity artifact, radiologist confidence, ability to render a definitive diagnosis, and identification of emergent or important findings for all MRI examinations were assessed. These same features were evaluated on 5 computed tomographies performed after fluoroscopy (before the MRI) in the same cohort.
Results:
All 31 MRI examinations performed after fluoroscopic studies with concentrated barium or iodine solutions were diagnostic for answering the clinical question according to radiologist and report review, regardless of magnet strength and type of fluoroscopic contrast ingested. Magnetic resonance imaging after fluoroscopy had excellent overall image quality (mean score, 4.74/5), minimal to no artifact emanating from bowel (mean, 4.63/5), minimal inhomogeneity artifact (mean, 4.38/5), and excellent diagnostic confidence (mean, 4.98/5). No additional imaging was necessary for diagnosis after MRI. Computed tomography after fluoroscopy had lower overall image quality, more image artifacts, and lower diagnostic confidence (P < 0.05).
Conclusions:
Magnetic resonance imaging is a useful tool for evaluating patients with retained concentrated enteric contrast from recent fluoroscopic examinations. In the absence of contraindication, MRI should be considered in the evaluation of urgent clinical problems in patients who recently underwent a fluoroscopic bowel evaluation.
Insights
Magnetic resonance imaging (MRI) is effective for diagnosing patients with residual contrast after fluoroscopic bowel evaluations. This imaging modality offers high quality, minimal artifacts, and excellent diagnostic confidence, proving superior to computed tomography in this scenario.
Area of Science:
- Radiology
- Medical Imaging
- Gastrointestinal Imaging
Background:
- Fluoroscopic bowel examinations utilize barium or iodine contrast agents.
- Retained contrast can obscure visualization in subsequent imaging studies.
- Assessing the utility of MRI after fluoroscopy is crucial for diagnostic accuracy.
Purpose of the Study:
- To evaluate magnetic resonance imaging (MRI) quality and diagnostic performance after fluoroscopic bowel examinations.
- To compare MRI with computed tomography (CT) in patients with retained contrast.
- To determine the overall utility of MRI in this specific clinical setting.
Main Methods:
- Retrospective review of 31 MRI examinations performed after fluoroscopic bowel evaluations (barium or iodine contrast).
- Assessment of image quality, artifacts, radiologist confidence, and diagnostic capability.
- Comparison with 5 CT scans performed after fluoroscopy in the same patient cohort.
Main Results:
- All 31 MRI examinations were diagnostic, irrespective of contrast type or magnet strength.
- MRI demonstrated excellent image quality (4.74/5), minimal artifacts (4.63/5), and high diagnostic confidence (4.98/5).
- CT scans showed significantly lower image quality, more artifacts, and reduced diagnostic confidence compared to MRI (P < 0.05).
Conclusions:
- Magnetic resonance imaging is a valuable tool for evaluating patients with retained enteric contrast after fluoroscopy.
- MRI provides superior diagnostic performance compared to CT in this context.
- MRI should be considered for urgent clinical problems in patients who recently underwent fluoroscopic bowel evaluation, barring contraindications.
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