MR Enterography

Overview

• Special exam used to evaluate bowel and specifically bowel wall

• Give a neutral contrast agent before exam which patient should drink in increments

  • Drink in increments so that it goes throughout the whole intestines/colon, if you drink all at once then will just be in the stomach and no bueno

• Glucagon is sometimes given to stop peristalsis and to evaluate the bowel

• Typical sequences are used with a special one not frequently used elsewhere

  • Jiggle sequence - steady state free procession - used to visualize peristalsis and evaluate if any area is not moving/paralyzed/ileus that sort of thing

• When evaluating you should comment on test adequacy, specifically, is the contrast agent noted throughout all of the bowel or only in some parts and not others (sub-optimal)

In the two images below, note the thickness of the terminal ileal wall compared to the rest of the bowel. It is noticeably thicker than normal bowel wall which is irregular.