MR Enterography in Small IntestinalLesions in Children

Abstract

Small bowel is affected by a group of diseases that can be categorized into inflammatory bowel disease, small bowel neoplasm, infections and congenital diseases. Inflammatory bowel diseases particularly crohns disease are characterized by unpredictable periods of remissions and exacerbations. Diagnosis of small bowel diseases requires both the clinical information, and the important role of the radiologic imaging. Few years ago, barium studies and endoscopy were considered the dominant modalities in evaluation of small bowel diseases with endoscopic guided biopsy and histopathological verification. However, the introduction of multislice CT and MRI technologies began to change this concept as these new imaging modalities enabled faster acquisition of a larger amount of information and led to better details of the intestines and mesenteries. MDCT and CT enterography have a disadvantage of involving considerable ionizing radiation exposure especially in patients with inflammatory bowel diseases who were diagnosed early in life and require frequent follow up imaging. Recently, advances in magnetic resonance imaging (MRI) technology with the introduction of fast MRI sequences and three-dimensional post-processing abilities offer sensitive and radiation free imaging for small bowel inflammatory diseases with proper evaluation of abnormalities of the small bowel wall and extra-luminal changes.