MRI of the Small Bowel

Imaging improvements gained by using MR enteroclysis and MR enterography in assessing small bowel morphology and functional are presented.

Course ID: Q00352 Category:
Modalities: ,

3.0

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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.00
Procedures: 1.00
Abdomen and Pelvis: 1.00

Magnetic Resonance Imaging: 2.50
Patient Care: 0.25
Patient Interactions and Management: 0.25
Image Production: 0.25
Sequence Parameters and Options: 0.25
Procedures: 2.00
Body: 2.00

Radiography: 1.00
Procedures: 1.00
Thorax and Abdomen Procedures: 1.00

Registered Radiologist Assistant: 2.25
Patient Care: 0.25
Pharmacology: 0.25
Procedures: 2.00
Abdominal Section: 2.00

Radiation Therapy: 2.00
Patient Care: 1.00
Patient and Medical Record Management: 1.00
Procedures: 1.00
Treatment Sites and Tumors: 1.00

Outline

  1. Introduction
  2. Technical Considerations
    1. Enteral Contrast Agents for MR Imaging
    2. MR Techniques: Enterography and Enteroclysis
    3. MR Imaging Protocol and Pulse Sequences
    4. The Use of Intravenous Contrast Material
    5. Image Interpretation
  3. Clinical Indications
    1. Crohn Disease
    2. Small-Bowel Neoplasms
    3. Celiac Disease
    4. Small-Bowel Obstruction
  4. Conclusion

Objectives

Upon completion of this course, students will:

  1. list the methods for evaluating the small bowel
  2. know what pathology is best imaged with traditional barium studies
  3. list the disadvantages of ultrasound imaging of the bowel
  4. be familiar with the wireless capsule endoscopy procedure
  5. understand what information CT provides about the small bowel
  6. understand what information MRI provides about the small bowel
  7. know the characteristics of positive contrast enteral agents
  8. name the only negative contrast agent available in the United States
  9. know what types of contrast can be created using VoLumen
  10. recognize the appearance of biphasic enteral contrast on MR imaging sequences
  11. know the characteristics of MR enterography and MR enteroclysis
  12. describe the ligament of Treitz
  13. understand why a radiologist must be present during bowel distention
  14. know how much enteral contrast material to use for MR enterography
  15. be familiar with the transit time of enteral contrast media after oral ingestion
  16. list the characteristics of MR enteroclysis
  17. understand why fasting is important prior to MR enteroclysis or enterography
  18. know the benefits positioning the patient in a prone orientation
  19. describe what MR scanner attributes are required for enterography or enteroclysis examinations
  20. name the reasons for getting adequate anatomic coverage for MR enterography or enteroclysis
  21. describe the features of the jejunum
  22. identify the contrast seen on balanced gradient-echo MR images
  23. know what field of view (FOV) is recommend for most bowel imaging sequences
  24. know the medications given to reduce peristalsis of the bowel
  25. list reasons for acquiring 3D instead of 2D MR images
  26. understand the importance of gadolinium chelate intravenous contrast media in diagnosing Crohn disease
  27. be familiar with the use of dynamic contrast-enhanced perfusion imaging
  28. know the criteria for diagnosing low-grade stenosis of the bowel
  29. know what bowel wall thickness is considered abnormal in a distended small bowel loop
  30. identify the causes of reversible and nonreversible lumen narrowing
  31. be familiar with the major types of inflammatory bowel disease
  32. identify the early changes that are seen with Crohn disease
  33. describe the appearance of deep linear ulcers on T2-weighted images
  34. be familiar with the imaging-based classification system for Crohn disease
  35. identify the most sensitive imaging finding in active Crohn disease
  36. name the imaging sequence that best demonstrates the comb sign
  37. characterize abscesses in the bowel wall
  38. be aware of the limitations of MR imaging in categorizing Crohn disease activity
  39. know what the preferred method of small bowel imaging is
  40. list the associated signs of malignant forms of small bowel obstruction