RESUMEN
PURPOSE: This study assessed the value of high-resolution magnetic resonance imaging (MRI) of the distal colon by means of a dedicated endoluminal magnetic resonance receiver coil on a 1.5-T clinical scanner. MATERIALS AND METHODS: To this end, single-loop, receive-only radio-frequency coils, housed in 18 F sheaths, were built. A 1.5-T clinical imager was used. A 18 French diameter internal MRI receiver coil was inserted into the distal colon in 15 New Zealand rabbits to obtain high-resolution magnetic resonance images by using T1-weighted Flash sequences with and without Fat Saturation (FS), T2-weighted True-Fisp, turbo spin-echo, and T1-weighted Flash FS after contrast media injection. Images were compared to histological sections. RESULTS: An adequate image quality was obtained in all specimens without significant artefacts. Based on histological reports, a five-layer structure of the wall was considered normal. On different MR sequences, only two layers were identified on the images of all rabbits specimens. The nearest layer to the mucosal surface was usually seen as a hyper intense layer and likely corresponds to the mucosa. The highest difference of signal value between internal and external layers was performed on 2D Fat saturation T1 weighted gradient echo. Comparison of mean signal value between the internal and external layers was statistically different in for each sequence used in our protocol (P < 0.05). CONCLUSION: Dedicated endoluminal RF coil provides good spatial resolution at the region of interest. On this prospective study of in vivo rabbit, evaluation of colon walls allowed to provide detailed information.
Asunto(s)
Cateterismo , Colon/patología , Aumento de la Imagen/instrumentación , Imagen por Resonancia Magnética/instrumentación , Magnetismo/instrumentación , Transductores , Animales , Aumento de la Imagen/métodos , Imagen por Resonancia Magnética/métodos , Conejos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
AIM: To evaluate the value of gadolinium enhanced MRI with oral opacification using a 5% mannitol solution (CE-Mannitol-MRI) to reveal bowel inflammation in pediatric patients with known or suspected Crohn's disease (CD). MATERIALS AND METHODS: Sixty-two consecutive children (median age 13.9 years) with known or suspected CD underwent ileocolonoscopy with biopsy, ultrasonography and CE-Mannitol-MRI. CD activity was measured with the Pediatric Crohn's Disease Activity Index (PCDAI). Image quality, wall thickness, bowel wall enhancement and complications identified on CE-Mannitol-MRI were evaluated by two blinded radiologists. RESULTS: The sensitivity and specificity of CE-Mannitol-MRI for the diagnosis of CD were 83% and 100%, respectively. Bowel wall enhancement was higher in the group of patients with abnormal small bowel loops versus control group (P = 0.001). In patients with known CD, there was a positive correlation between wall thickness and PCDAI (P = 0.003). However, no significant correlation was demonstrated between parietal contrast enhancement and PCDAI (P = 0.497). CE-Mannitol-MRI enabled identification of complications in 18 patients (9 fistulae, 8 strictures and 1 intussusception). CONCLUSION: In pediatric patients with CD, CE-Mannitol-MRI contributes significantly to the identification of disease extension, severity and intestinal complications with adequate diagnostic accuracy. This technique could also be useful as the first line diagnostic exploration in young patients with suspected CD.