Pyodermatitis-Pyostomatitis Vegetans Associated with Crohn ...
Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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ORIGINAL ARTIC LE Feasibility of 3-T MRI for the evaluation of Crohn disease in children Charuta Dagia & Michael Ditchfield & Michael Kean & Anthony Catto-Smith Received: 11 May 2009 /Revised: 7 December 2009 /Accepted: 8 January 2010 /Published online: 6 August 2010 # Springer-V erlag 2010 Abstract Background Crohn disease (CD) is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract from the oral cavity to the anal canal. It occurs in all ages and is a significant cause for morbidity in children. Interest in MRI evaluation of CD has increased because of the con cer n regarding cumula tive rad iat ion dose from contrast fluoroscopic studies and CT. Several reports have demonstrated MRI to be a useful technique for CD. Most of these studies were performed at 1. 5-T field strength. Imaging at a higher field strength, with a greater signal- to-noise ratio, has the potential of reducing scan times and inc reas ing the reso luti on. Howeve r, the re is a concur rent inc rease in arte fact s, and these can be pronou nced with abdominal imaging at 3 T. Objective To determine the feasibility of 3-T MRI for CD in children and to assess the value of different sequences and the effect of artefacts that could potentially limit the role of bowel MR imaging at higher field strengths. Materials and methods A retrospective study of 46 children with biopsy-proven CD (ages 8 – 19 years, 53% boys) was pe rfor med. Sixty-eight consecutive MRI studies were performed on a 3-T scanner between 2005 and 2007; 42 of the abdomen (62 %) and 26 of the pelvis/pe rin eum (38%). Sorbitol was administered for the abdomi nal st udies; or al ly for 36/42 (86%) st udies and vi a a na so- jejunal (NJ) tube for 6/42 (14%) studies. For the abdomen, T2-W half-fourier acquisition single-shot turbo spin-ec ho (T2-W HAST E), true ste ady -state fre e preces sion (tru e FISP), pre-contras t and contras t-enha nced (CE) T1-vo lume interp olated gradient- echo (T1-W VIBE) and CE T1-W fast low-an gle shot (T1-W FLASH) sequence s were performed. For the perianal and pelvic assessment, fat-saturated T2-W turbo spin-echo (TSE), pre-contrast and CE T1-W FLASH or VIBE sequences were performed. The sequences were scored for diagnostic quality by two paediatric radiologists for vi sual isa tio n of the bowel wall, whet her norma l or pathological and the visual ization of extra intestina l mani festa tions. The effe cts of dist ensi on, susc epti bili ty artefact and motion were assessed. Results Six (14%) abd omin al MRI studies were nor mal. Thirty-six (86%) were abnormal with good correlation with endoscopic findings. The pelvic and perianal MRI studies wer e all abn orma l (26/26, 100 %) with goo d cor rela tion with proctoscopy and examination under anaesth esia. All the sequences had high average scores (greater than or close to 3), except true FISP with a score of 2.4. The score was gre ates t in those who had NJ administration of sor bito l; howeve r, satisfactory distensi on was also possib le with oral administration of contrast. Tr ue FISP was the sequen ce most affected by a combination of suboptimal distension and artefact from colonic contents. With adequate disten- sion, true FISP imag e qua lity impr oved remarkably . The overa ll sco re of this sequence was satis facto ry in the absence of susceptibility and movement artefact. Conclusion With appropria te attentio n to techn ique, with optimal distension and control of movement, high-quality, 3-T asse ssment of the abdome n, pel vis and perine um is possible. All sequences used at 1.5 T can be used at 3 T, however true FISP was the most prone to artefact. C. Dagia : M. Ditch field ( *) : M. Kean Department of Medical Imaging and Murdoch Childrens Research Instit ute, The Royal Children ’s Hospital, Flemington Road, Parkville, Victoria 3052, Australia e-mail: [email protected] A. Catto-Smith Department of Gastroenterology, The Royal Children ’s Hospit al, Victoria, Australia Pediatr Radiol (2010) 40:1615 – 1624 DOI 10.1007/s00247-010-1781-9
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Transcript of Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
http://slidepdf.com/reader/full/feasibility-of-3-t-mri-for-the-evaluation-of-crohn-disease-in-children 1/10
8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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8/7/2019 Feasibility of 3-T MRI for the Evaluation of Crohn Disease in Children
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