Division of Pediatric Gastroenterology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
AJR Am J Roentgenol. 2012 Sep;199(3):W367-75. doi: 10.2214/AJR.11.8363.
The purpose of this article was to evaluate image quality, oral contrast administration and bowel distention, side effects, and performance estimates of MR enterography in a large cohort of pediatric patients with inflammatory bowel disease (IBD).
A retrospective analysis of the pediatric IBD clinic database (2007-2010) was performed. Eighty-five MR enterography studies in 70 patients were performed without sedation. All pediatric patients with the potential diagnosis of IBD were included, with the exception of studies performed on patients with ileoanal pouch anatomy. The quantity of ingested oral contrast material and number of adverse events were recorded. Retrospectively, image quality (including motion artifact and bowel distention) and enteric inflammation were assessed. Correlation between radiographic findings and endoscopic findings was tested by the Fisher exact test.
Eighty-five MR enterography studies were performed without sedation in 70 patients (mean age, 15.6 years; age range, 9-18 years) over 30 months. The mean image quality for unenhanced images was significantly higher than for contrast-enhanced images (4.7 vs 4.1, p < 0.0001), with unacceptable image quality occurring on both unenhanced and contrast-enhanced sequences in one patient. The amount of oral contrast material ingested correlated with patient age (p = 0.009), with acceptable bowel distention occurring in 93% (78/85). Two patients had nausea or emesis and one experienced a syncopal episode after MR enterography. Sensitivity and specificity of MR enterography for active disease of the terminal ileum, right colon, and left colon were 80% and 85.2%, 79.1% and 77.8%, and 90.3% and 63.6%, respectively.
MR enterography is feasible in patients 9 years old and older without sedation. Acceptable image quality can be achieved in nearly all patients, but a small minority will have suboptimal bowel distention or minor adverse events. Oral contrast ingestion regimes can be based on patient age. Performance estimates in children parallel reports in adults.
本文旨在评估在患有炎症性肠病（IBD）的大样本儿科患者中，磁共振肠造影术的图像质量、口服造影剂的使用、肠道扩张、不良反应和性能估计。
对儿科 IBD 诊所数据库（2007-2010 年）进行回顾性分析。对 70 例患者的 85 例磁共振肠造影术进行了无镇静检查。所有可能诊断为 IBD 的儿科患者均包括在内，但排除了具有回肠肛管解剖结构的患者。记录口服造影剂的用量和不良反应的发生情况。回顾性评估图像质量（包括运动伪影和肠道扩张）和肠内炎症。采用 Fisher 精确检验检验影像学表现与内镜检查结果的相关性。
在 30 个月内，对 70 例（平均年龄 15.6 岁；年龄范围 9-18 岁）患者的 85 例磁共振肠造影术进行了无镇静检查。未增强图像的平均图像质量明显高于增强图像（4.7 比 4.1，p <0.0001），1 例患者的未增强和增强序列图像质量均不可接受。口服造影剂的用量与患者年龄相关（p = 0.009），93%（78/85）的患者肠道扩张可接受。2 例患者出现恶心或呕吐，1 例患者在磁共振肠造影术后出现晕厥。磁共振肠造影术对末端回肠、右结肠和左结肠活动性疾病的敏感性和特异性分别为 80%和 85.2%、79.1%和 77.8%以及 90.3%和 63.6%。
无镇静剂可对 9 岁及以上患者进行磁共振肠造影术。几乎所有患者均可获得可接受的图像质量，但少数患者肠道扩张不理想或出现轻微不良反应。口服造影剂的摄入方案可以根据患者年龄制定。儿童的性能估计与成人报告相似。
