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Magnetic Resonance Enterography (MRE)

Magnetic Resonance Enterography (MRE) is a noninvasive imaging test that can evaluate gastrointestinal issues including Inflammatory Bowel Disease. Unlike a Computed Tomography Enterography (CTE), a MRE does not utilize radiation so can be useful for younger patients or those who have already had too much radiation exposure. One thought is to utilize CTE for initial diagnosis and then MRE for ongoing checkups.

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Data

Advantages of MRE over CTE

- MRE does not use ionizing radiation to produce images. As people with IBD often require many scans over their lifetime, radiation exposure becomes a concern.

- Patient can be imaged with repeated sequences over time after injection of the contrast. But this allows for affected bowel segments to be repeatedly imaged for additional perspectives.

- Motion-sensitive techniques are as good as fluoroscopy in detecting hard to detect strictures and obstructions.

Disadvantages of MRE versus CTE

- Availability is a problem. MRE machines are usually taken up by patients with neurological or musculoskeletal issues. This is the primary reason one large company cites performing more CTEs than MREs.

- There are less MRE technicians than CTE technicians available with the skill to properly scan the abdomen for IBD.

- Due to the complexity of IBD, often a radiologist is needed to monitor the scan in real time.

- Antiperistaltic or antispasmodic agents such as glucagon or scopolamine must be used during the phase of the imaging where the bowel movements need to be stilled.

- Imaging studies with CTE tend to be higher quality

- CTE is cheaper than MRE

Preparation

- As an MRE utilizes a large magnet, do not wear any metal or jewelry of any kind.
- Arrive at the directed time to ensure plenty of time to consume the oral barium solution.

The Scan

- A large amount (around one liter) of a low-attenuation agent that you drink is provided that is meant to make the bowel easier to view and distend it. Usually you must drink this within about an hour.
- An IV will be inserted into your arm through which a dye (contrast) will be administered for better imaging results.
- Hearing protection and often music will be provided as the machine can be loud.
- The table you lie upon will slide into the machine. You will need to remain as still as possible to ensure excellent imagine results. You will be in constant contact with the MRE technician in case you or they need to communicate.
- The exam itself should last less than an hour and usually much less.

Crohn's Disease Findings with MRE

- Intestinal wall thickening usually of greater than 3mm.
- Wall hyperenhancement. Some people will experience thickening of the entire wall whereas others may just experience thickening of the inner wall leading to mural stratification which looks like a target.
- Narrowing of the intestines
- Peribowel vascular engorgement which is known as the "Comb Sign"
- Peribowel fat proliferation
- Strictures
- Fistulae
- Abscesses

References


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07-22-2012, 03:33 PM   #1
GrumpyGuts
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Very interesting, Thanks for the info David!
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11-09-2012, 12:37 PM   #2
Hope345
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My daughter is going to have an MRE next month due to being anemic again. We are questioning the need to have it since we already know she has Crohns Colitis and continues to bleed.

Any feedback would be helpful.
Very upset after 5 Remicade treatments she is still bleeding and now very anemic.
thank-you
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Daughter (age 17) diagnosed with Crohns Colitis/UC 1/2012 Mod/severe changed to U.C.: 11/7/2014 anemia:blood transfusion current: Flare, weaning from Prednisone, still bloating: Meds ,Pentesa: 2000mg twice daily, Vegan diet, mesalamine enemas .Previous: mercaptopurine, Remicade (13 treatments), Imuran, prednisone ), Flagyl, iron infusions, cortifoam,
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Daughter: age 21, undiagnosed: GI issues
11-10-2012, 08:02 PM   #3
David
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julie, they likely want to evaluate the extent of her disease, especially in areas of the small intestine where it's difficult to reach endoscopically. But if they haven't explained their reasoning, ask them.

As there isn't radiation with an MRE, I think letting them evaluate what's going on, if that is indeed the case, would be worthwhile.

Have they tested her for c.diff lately to make sure the bleeding isn't due to that? It's unfortunately relatively common in people with Crohn's and can mimic a flare.
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