Korean J Radiol.  2000 Mar;1(1):43-50. 10.3348/kjr.2000.1.1.43.

Usefulness of MR Imaging for Diseases of the Small Intestine: Comparison with CT

• Kim JH
• Ha HK
• Sohn MJ
• Shin BS
• Lee YS
• Chung SY
• Kim PN
• Lee MG
• Auh YH

• KMID: 1777295
• DOI: http://doi.org/10.3348/kjr.2000.1.1.43

Abstract

OBJECTIVE
To evaluate the usefulness of MR imaging for diseases of the small intestine, emphasizing a comparison with CT. MATERIALS AND METHODS: Thirty-four patients who underwent both CT and MR imaging using FLASH 2D and HASTE sequences were analyzed. All patients had various small bowel diseases with variable association of peritoneal lesions. We compared the detectabilities of CT and MR imaging using different MR pulse sequences. The capability for analyzing the characteristics of small intestinal disease was also compared. RESULTS: MR imaging was nearly equal to CT for detecting intraluminal or peritoneal masses, lesions in the bowel and mesentery, and small bowel obstruction, but was definitely inferior for detecting omental lesions. The most successful MR imaging sequence was HASTE for demonstrating bowel wall thickening, coronal FLASH 2D for mesenteric lesions, and axial FLASH 2D for omental lesions. MR imaging yielded greater information than CT in six of 12 inflammatory bowel diseases, while it was equal to CT in six of seven neoplasms and inferior in five of seven mesenteric ischemia. In determining the primary causes of 15 intestinal obstructions, MR imaging was correct in 11 (73%) and CT in nine (60%) patients. CONCLUSION: MR imaging can serve as an alternative diagnostic tool for patients with suspected inflammatory bowel disease, small intestinal neoplasm or obstruction. is a high-speed, heavily T2-weighted sequence with a great sensitivity for fluid (11). This advance may make it possible to use breath-hold turbo spin-echo MR.

Keyword

Gastrointestinal tract, diseases; Gastrointestinal tract, MR; Gastrointestinal tract, CT; Magnetic resonance (MR),comparative studies

MeSH Terms

Comparative Study
Female
Human
Inflammatory Bowel Diseases/*diagnosis
Intestinal Neoplasms/*diagnosis
Intestinal Obstruction/*diagnosis
Intestine, Small/*pathology
*Magnetic Resonance Imaging
Male
Middle Age
*Tomography, X-Ray Computed

Figure

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  Fig. 1 Intestinal ischemia in a 74-year-old man. A. Contrast-enhanced CT scan shows bowel wall thickening with a target sign (arrows). Note regional mesenteric haziness and vascular engorgement (arrowheads). B. Coronal HASTE MR image shows target sign in thickened bowel wall (arrows).

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  Fig. 2 Tuberculous peritonitis in a 24-year-old woman. A. Coronal FLASH 2D MR image shows miliary implants scattered in the mesentery (M). A loculated intraperitoneal fluid collection (F) is also noted. B. Contrast-enhanced CT scan shows better visualization of miliary lesions in the greater omentum and mesentery as well as ascites.

• 

  Fig. 3 A 35-year-old man with Crohn s disease. A. Coronal HASTE MR image demonstrates eccentric bowel wall thickening along mesenteric borders (arrows) of the bowel loops. Note bowel separation due to fibrofatty proliferation (arrowheads). B. Small bowel follow through shows marginal ulcer (arrowheads) along the mesenteric border of the small intestine. Note inflammatory stricture (arrows) of pelvic bowel loop along with regional bowel separation due to inflammatory infiltrates and fibrofatty proliferation.

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  Fig. 4 Leiomyosarcoma of the jejunum in a 71-year-old man. A. Contrast-enhanced CT scan shows a poorly enhanced soft tissue mass (*) in the pelvis, partially attaching to the adjacent bowel. B. Coronal HASTE MR image shows a hyperintense soft tissue mass (straight arrows). In contrast to CT image (A), lobulated configuration is well demonstrated on this image. Intestinal loop (curved arrow) is entrapped within the mass lesion.

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  Fig. 5 Intestinal lymphoma developing intussusception in a 30-year-old woman. A. Contrast-enhanced CT scan shows minimal bowel wall thickening (arrows) in the contrast-filled small intestinal loops as well as evidence of intussusception (*). At surgery, intussusception developed secondary to a polypoid intraluminal mass in the ileum. B. Coronal HASTE MR image also shows intussusception (arrows) and minimal bowel wall thickening (arrowheads).

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  Fig. 6 Simple intestinal obstruction due to bowel adhesions in a 55-year-old man. A. Contrast-enhanced CT scan shows end-on view of narrowed intestinal segment (arrows) just proximal to the obstructed site. B. Coronal HASTE MR image shows diffuse dilatation of small intestinal loop with tapered narrowing at the obstructed site (curved arrow).

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