MRI with oral filling in patients with chronic inflammatory bowel diseases

Aim. Evaluation of mannitol-MRI in patients with suspected or established Crohn's disease (CD). Methods. 75 patients with suspected or established Crohn's disease were included. 1.51 of mannitol-solution were administered orally within I h before imaging. A rectal filling was also employed. Butylscopolamin was applied i.v. Native-sequences were acquired. T1w sequences (axial, coronal) were acquired before and after (fs-T1-w-BH) i.v. Gd-DTPA. Additionally a dynamic CM-study was performed. Results. In 45% of the examinations good image quality was achieved. In 28% opacification of the terminal ileum was insufficient. However, diagnostic assessment was possible. Motion artifacts due to breathing were rare, artifacts due to peristalsis were noted in 16% of the examinations. Alterations indicative to CD were found in 69% of the patients. The SI-increase of the thickened bowel-wall was significantly higher than the increase of not thickened wall (117 vs. 75%; p = 0,001 in t-test). We detected stenoses in 56%, fistulas in 23% and an abscess in one patient. Conclusion. Mannitol-MRI is a valuable method in the diagnostic work-up of inflammatory bowel disease. Improvement of distal distension should be attempted, because of the good acceptance of the patients and high diagnostical value.