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Crohn's Disease Forum » Tests for IBD » What MRI-MRE tests do you recommend?


07-21-2014, 09:02 PM   #1
Jay Woodman
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What MRI-MRE tests do you recommend?

I have Perianal Crohn's and am currently scheduled for a Pelvic MRI. I currently have a number of setons in place & these will have to be removed temporarily prior to the Pelvic MRI. The setons are held together with metal clamps thus their removal is required for the MRI! I understand setons may also cause artifact if not removed. I have read that the Endoanal MRI May provide a more detailed image for Perianal Crohns (ie.Fistula tracts). Has anyone had the Endoanal MRI done? Is there a preference for the Endoanal MRI versus the Pelvic MRI or should I see if I can have both tests done?

While I have the setons removed I would really like an MRE of the small bowel. I have had one Colonoscopy of the colon but no assessment yet of the small bowel. My GI has not raised the issue of a small bowel investigation rather it has been my line of questioning. I felt badly for raising this request during my last appointment. Am I unreasonable to ask for small bowel investigation?

I thought the temporary removal of the setons would be an ideal time to ensure I have a thorough baseline assessment via all options of MRI's - MRE 's that are available for Crohns patients. I have currently been advised by my GIs office that the Radiologist said I do not meet the criteria for a Small Bowel MRE & must have a CT Enterography instead.

What has been your experience in MRI-MRE testing? What is reasonable in investigating our disease? What is standard protocol? Why wouldn't I meet criteria for a small bowel MRE? What tests has your GI required?
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07-22-2014, 12:44 AM   #2
Patricia56
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Can't address the question of the pelvic vs. endoanal MRI. Hopefully someone will come along who can. You might want to post in the support section where they get more traffic that you need support around that issue and to see your post in this section.

I think it is perfectly appropriate for you to request small bowel imaging. Just because you don't have symptoms right now doesn't mean something isn't going on in your gut.

I can't address why you wouldn't qualify for an MRE. I would ask the GI about it and see if he'll push for one since you don't want the high radiation load that comes with a CT scan. You are already at risk for GI cancer you don't need to add to that risk with a CT scan.

I see you aren't on any meds - are you considering Remicade which is well known for efffective treatment of perianal disease?

Hope your scans go well and that you are able to get treatment to heal the fistulas quickly.
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Nothing I say here should be construed as medical advice. I am not a doctor. These are just my opinions.
07-22-2014, 07:58 AM   #3
nogutsnoglory
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MRE of the pelvis with anal fistula protocol is excellent at imaging what's going on down below. It's about a 30 min exam.
07-22-2014, 08:35 AM   #4
Jay Woodman
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Can't address the question of the pelvic vs. endoanal MRI. Hopefully someone will come along who can. You might want to post in the support section where they get more traffic that you need support around that issue and to see your post in this section.

I think it is perfectly appropriate for you to request small bowel imaging. Just because you don't have symptoms right now doesn't mean something isn't going on in your gut.

I can't address why you wouldn't qualify for an MRE. I would ask the GI about it and see if he'll push for one since you don't want the high radiation load that comes with a CT scan. You are already at risk for GI cancer you don't need to add to that risk with a CT scan.

I see you aren't on any meds - are you considering Remicade which is well known for efffective treatment of perianal disease?

Hope your scans go well and that you are able to get treatment to heal the fistulas quickly.
Thanks Patricia! I am currently on Rifampin for treatment of latent TB. My GI has recommended Humira as soon as I complete the Rifampin.
07-22-2014, 08:49 AM   #5
Jay Woodman
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MRE of the pelvis with anal fistula protocol is excellent at imaging what's going on down below. It's about a 30 min exam.
Thanks for the suggestion! I'll have to research a few official radiology sites to determine what MRE of the pelvis with anal fistula protocol means : ) That's why I appreciate this Forum so much. Without others input & my interest in researching options, right now, I would be limited to a pelvic MRI & CT MRE. As a patient, I'm learning that one can't assume that the presecribed options are the only ones that are available because that's what my medical experts are recommending : ) It's a very difficult situation for a Crohns patient when you are asking your GI for options other than the recommended ones!
07-22-2014, 08:52 AM   #6
nogutsnoglory
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Yes, you gotta be your own advocate. I have had the fistula protocol a few times but I don't know what to say about it besides it's very conclusive. It may only be preformed at clinics that deal with IBD since it's a specialized exam.
07-22-2014, 11:15 AM   #7
valleysangel92
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I can't offer you any advice regarding which type of MRI to ask for, but I do want to echo what some of the others have said.

It is absolutely ok to ask your doctor for specific investigations or to at least raise a question with them if you feel there is something more going on.

It's very easy to feel like you can't or shouldn't question your doctors, I mean they are the ones who trained for years to do this, so they should know best, right? However, it's very easy for them to forget minor details and over look certain things. Some doctors even work on the basis that if it's not bad enough for the patient to complain about it then it's not bad enough for them to investigate either.

Remember that you know your body best, if there is something bothering you make sure you bring it up and make sure they listen. If your doctor makes you feel as though you cannot ask them questions or bring up your own concerns then maybe they aren't the right doctor for you. I know I will often trust my doctors far more if they allow me to ask questions and even pick up on things that don't seem right than if they make me feel like their word is the law and what I feel and want is not important.
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