The role of MR enterography in the diagnosis of IBD and other small bowel diseases from a gastroenterologist perspective

Introduction and objective: There are many patients examined with abdominal pain and diarrhoea in our outpatient department of gastroenterology. Disease or inflammation of the small bowel comes up quite often as a possible reason. MR enterography, which was introduced four years ago as a new method in our hospital, proved to be a very useful diagnostic procedure. In our lecture we summarize wich symptoms and former diagnostic results indicated this method and how it helped us in the further treatment.

Patients and methods: MR enterography was performed in 55 cases in the past 4 years in order to prove or exclude inflammation, stenosis, abscessus, fistula or tumor located mainly in the ileum.

Results: In 26 cases CD has been cofirmed concordantly to the clinical symptoms. 4 cases proved to be UC. 2 cases were tumor, one of them NET with metastases in the liver. 1 malignancy of the kidney connected to fistulizing CD, and 1 panniculitis were found. In 9 cases the final diagnosis became IBS (2 of them working in our hospital). In our lecture we analyse five instructive cases in detail with the findings of endoscopy, pathology, ultrasound, small bowel enterography and MR enterography.

Conclusions: Inital experiences suggest that MR enterography is a sensitive and specific method in the diagnosis of CD and small bowel tumors. It helped in the differentiation of UC, IBS celiac disease, too. It helped us to recognize the most serious cases which were followed by operation, intensive treatment or biological therapy. Collaborating with the radiologist we optimalized the preparation and examination protocol in order to get the best imaging. It is well tolerable and considering the young age of the patients highly important that against other radiologocal methods it is free of radiation.