Endoskopie heute 2013; 26(2): 130-133
DOI: 10.1055/s-0033-1335511
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Magnetresonanztomografie (MRT) in der Gastroenterologie

Magnetic Resonance Tomography in Gastroenterology
J. G. Albert
1   Medizinische Klinik 1, Klinikum der J.-W.-Goethe-Universität, Frankfurt
,
H. E. Adamek
2   Medizinische Klinik 2, Klinikum Leverkusen
› Author Affiliations
Further Information

Publication History

Publication Date:
16 July 2013 (online)

Zusammenfassung

Die Magnetresonanztomografie (MRT) steht heute als wichtige komplementäre Methode der Endoskopie zur Seite. Damit wird eine invasive endoskopische Diagnostik – beispielsweise im Bereich der Darstellung der Gallenwege oder des Pankreasgangsystems durch die endoskopisch-retrograde Cholangiopankreatografie (ERCP) – nur noch sehr selten nötig und ist weitgehend durch die MR- Cholangiopankreatografie (MRCP) ersetzt. Hervorragend ergänzt werden die bildgebenden Methoden zudem durch den endoskopischen Ultraschall. Nicht mehr wegzudenken ist der Einsatz der MRT bei den chronisch-entzündlichen Darmerkrankungen beispielsweise im Nachweis eines Dünndarmbefalls bei Morbus Crohn und in der Abklärung von Veränderungen der Leber.

Hieraus folgt für die endoskopischen Methoden eine Verschiebung der Indikationsstellung hin zur therapeutischen Intervention.

Abstract

Magnetic-resonance imaging (MRI) has become one of the most important diagnostic partners of endoscopic methods in gastroenterology: MR-cholangiopancreatography (MRCP) mostly replaced endoscopic-retrograde cholangiopancreatography (ERCP) to diagnose biliary and pancreatic disease; MRI is important in visualizing small bowel involvement in Crohn’s disease and predominant in differentiating liver lesions. Thus, invasive endoscopic methods are retreating from exclusively diagnostic indications and are increasingly used for therapeutic treatment.

 
  • Literatur

  • 1 Adamek HE, Lauenstein TC, (Hrsg.). MRT in der Gastroenterologie: MRT und bildgebende Differenzialdiagnose; 29 Tabellen. Stuttgart: Thieme; 2010
  • 2 Wallner BK, Schumacher KA, Weidenmaier W et al. Dilated biliary tract: evaluation with MR cholangiography with a T2-weighted contrast-enhanced fast sequence. Radiology 1991; 181: 805-808
  • 3 Adamek HE, Albert J, Weitz M et al. A prospective evaluation of magnetic resonance cholangiopancreatography in patients with suspected bile duct obstruction. Gut 1998; 43: 680-683
  • 4 Adamek HE, Albert J, Breer H et al. Pancreatic cancer detection with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography: a prospective controlled study. Lancet 2000; 356: 190-193
  • 5 Albert J, Schilling D, Breer H et al. Mucinous cystadenomas and intraductal papillary mucinous tumors of the pancreas in magnetic resonance cholangiopancreatography. Endoscopy 2000; 32: 472-476
  • 6 Albert JG, Riemann JF. ERCP and MRCP – when and why. Best Pract Res Clin Gastroenterol 2002; 16: 399-419
  • 7 Perez-Johnston R, Sainani NI, Sahani DV. Imaging of chronic pancreatitis (including groove and autoimmune pancreatitis). Radiol Clin North Am 2012; 50: 447-466
  • 8 Lauenstein T, Adamek H. Moderne Bildgebung bei Pankreasraumforderungen. Gastroenterologe 2012; 7: 347-357
  • 9 Meagher S, Yusoff I, Kennedy W et al. The roles of magnetic resonance and endoscopic retrograde cholangiopancreatography (MRCP and ERCP) in the diagnosis of patients with suspected sclerosing cholangitis: a cost-effectiveness analysis. Endoscopy 2007; 39: 222-228
  • 10 Adamek HE, Weitz M, Breer H et al. Value of magnetic-resonance cholangio-pancreatography (MRCP) after unsuccessful endoscopic-retrograde cholangio-pancreatography (ERCP). Endoscopy 1997; 29: 741-744
  • 11 Albert J, Breer H, Scheidt T et al. Chronisch entzündliche Darmerkrankungen: Die Magnetresonanztomographie im Spektrum der modernen Diagnostik. Dtsch Med Wochenschr 2002; 127: 1089-1095
  • 12 Bourreille A, Ignjatovic A, Aabakken L et al. Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED-ECCO consensus. Endoscopy 2009; 41: 618-637
  • 13 May A, Albert J, Keuchel M et al. Kapselendoskopie in der Diagnostik von Dünndarmerkrankungen. Update des Positionspapiers der Sektion Endoskopie der DGVS, Stand 07/2010.. Z Gastroenterol 2010; 48: 1384-1404
  • 14 Albert J, Scheidt T, Basler B et al. Die Magnetresonanztomographie in der Diagnostik und Verlaufsbeobachtung des Morbus Crohn – Ist das konventionelle Enteroklysma noch erforderlich?. Z Gastroenterol 2002; 40: 789-794
  • 15 Albert JG, Kotsch J, Köstler W et al. Course of Crohn’s Disease Prior to Establishment of the Diagnosis. Z Gastroenterol 2008; 46: 1-6
  • 16 Albert JG, Martiny F, Krummenerl A et al. Diagnosis of small bowel Crohn’s disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut 2005; 54: 1721-1727
  • 17 Golder SK, Schreyer AG, Endlicher E et al. Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease. Int J Colorectal Dis 2006; 21: 97-104
  • 18 Tillack C, Seiderer J, Brand S et al. Correlation of magnetic resonance enteroclysis (MRE) and wireless capsule endoscopy (CE) in the diagnosis of small bowel lesions in Crohn’s disease. Inflamm Bowel Dis 2008; 14: 1219-1228
  • 19 Bocker U, Dinter D, Litterer C et al. Comparison of magnetic resonance imaging and video capsule enteroscopy in diagnosing small-bowel pathology: localization-dependent diagnostic yield. Scand J Gastroenterol 2010; 45: 490-500
  • 20 Jensen MD, Nathan T, Rafaelsen SR et al. Diagnostic accuracy of capsule endoscopy for small bowel Crohn’s disease is superior to that of MR enterography or CT enterography. Clin Gastroenterol Hepatol 2011; 9: 124-129
  • 21 Casciani E, Masselli G, Di Nardo G et al. MR enterography versus capsule endoscopy in paediatric patients with suspected Crohn’s disease. Eur Radiol 2011; 21: 823-831
  • 22 Rociu E, Stoker J, Eijkemans MJ et al. Normal anal sphincter anatomy and age- and sex-related variations at high-spatial-resolution endoanal MR imaging. Radiology 2000; 217: 395-401
  • 23 Adamek HE, Schantzen W, Rinas U et al. Ultra-high-field magnetic resonance enterography in the diagnosis of ileitis (Neo-)terminalis: a prospective study. J Clin Gastroenterol 2012; 46: 311-316
  • 24 Adamek HE, Dietrich CF. Schnittbildverfahren in der Dunndarmdiagnostik: Was hat sich verbessert?. Internist 2010; 51: 722-729
  • 25 Albert JG, Lubbert C, Surow A et al. Die Divertikelkrankheit des Dünndarms im Zeitalter der Dünndarmendoskopie. Z Gastroenterol 2009; 47: 674-681
  • 26 Thornton E, Morrin MM, Yee J. Current status of MR colonography. Radiographics 2010; 30: 201-218
  • 27 Hartmann D, Bassler B, Schilling D et al. Incomplete conventional colonoscopy: magnetic resonance colonography in the evaluation of the proximal colon. Endoscopy 2005; 37: 816-820
  • 28 Ajaj W, Lauenstein TC, Pelster G et al. MR colonography in patients with incomplete conventional colonoscopy. Radiology 2005; 234: 452-459
  • 29 Hartmann D, Bassler B, Schilling D et al. Colorectal polyps: detection with dark-lumen MR colonography versus conventional colonoscopy. Radiology 2006; 238: 143-149
  • 30 Hartmann D, Bassler B, Pfeifer B et al. Patientenakzeptanz der MR-Kolonographie: Eine prospektive Erhebung im Vergleich zur konventionellen Koloskopie. Dtsch Med Wochenschr 2006; 131: 2519-2523
  • 31 Lauenstein TC, Debatin JF. Magnetic resonance colonography for colorectal cancer screening. Semin Ultrasound CT MR 2001; 22: 443-453
  • 32 Ajaj W, Pelster G, Treichel U et al. Dark lumen magnetic resonance colonography: comparison with conventional colonoscopy for the detection of colorectal pathology. Gut 2003; 52: 1738-1743
  • 33 Ajaj W, Ruehm SG, Gerken G et al. Strengths and weaknesses of dark-lumen MR colonography: clinical relevance of polyps smaller than 5 mm in diameter at the moment of their detection. J Magn Reson Imaging 2006; 24: 1088-1094
  • 34 Saar B, Gschossmann JM, Bonel HM et al. Evaluation of magnetic resonance colonography at 3.0 Tesla regarding diagnostic accuracy and image quality. Invest Radiol 2008; 43: 580-586
  • 35 Luboldt W, Bauerfeind P, Wildermuth S et al. Colonic masses: detection with MR colonography. Radiology 2000; 216: 383-388
  • 36 Pappalardo G, Polettini E, Frattaroli FM et al. Magnetic resonance colonography versus conventional colonoscopy for the detection of colonic endoluminal lesions. Gastroenterology 2000; 119: 300-304
  • 37 Saar B, Meining A, Beer A et al. Prospective study on bright lumen magnetic resonance colonography in comparison with conventional colonoscopy. Br J Radiol 2007; 80: 235-241
  • 38 Layer G, Adamek HE. Magentresonanztomografie in der Gastroenterologie. Gastroenterologe 2010; 5: 509-516
  • 39 Adamek HE, Breer H, Karschkes T et al. Magnetic resonance imaging in gastroenterology: time to say good-bye to all that endoscopy?. Endoscopy 2000; 32: 406-410