Ryan E Ronan, Heaslip Ingrid S E
Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Abdom Imaging. 2008 Jan-Feb;33(1):34-7. doi: 10.1007/s00261-007-9308-z.
Recent advances in CT and MR technology, particularly the advent of multidetector CT (MDCT), the advent of rapidly changing gradients in industry standard MRI scanners, enabling ultrafast sequences, have led to an expansion in the role of cross sectional imaging in the investigation of small bowel disorders. We conducted an evidence-based review of MR enteroclysis (MRE) and how it performs in comparison to CT enteroclysis (CTE) and the gold standard of conventional enteroclysis (CE) for diagnosis of small bowel Crohn's disease and small bowel neoplasia. We used the standard 5 step evidence-based medicine method of ask, search, appraise, apply and evaluate. We found 3 relevant level 1B studies, and one level 3B study. No studies evaluating MRE in small bowel neoplasia were found. MRE does not perform as well as CE in evaluation of fine mucosal detail, but the additional extraluminal detail, and absence of ionising radiation enhances its overall performance. It was not possible to establish the relative diagnostic performances of MRE and CTE from existing literature. CTE does involve patient irradiation. For patients in whom jejunal intubation and enteroclysis is considered to evaluate the small bowel, MRE should be considered the first-line investigation, local resources and expertise permitting.
CT和MR技术的最新进展，尤其是多排螺旋CT（MDCT）的出现，以及行业标准MRI扫描仪中快速变化梯度的出现，使得超快速序列成为可能，这导致了横断面成像在小肠疾病研究中的作用得到扩展。我们对磁共振小肠造影（MRE）进行了循证综述，以及它与CT小肠造影（CTE）和传统小肠造影（CE）的金标准相比，在诊断小肠克罗恩病和小肠肿瘤方面的表现如何。我们采用了循证医学标准的五个步骤：提问、搜索、评价、应用和评估。我们找到了3项相关的1B级研究和1项3B级研究。未找到评估MRE在小肠肿瘤中的研究。在评估精细黏膜细节方面，MRE的表现不如CE，但额外的腔外细节以及无电离辐射提高了其整体性能。从现有文献中无法确定MRE和CTE的相对诊断性能。CTE确实涉及患者接受辐射。对于考虑进行空肠插管和小肠造影以评估小肠的患者，在当地资源和专业知识允许的情况下，MRE应被视为一线检查方法。
