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磁共振小肠造影与磁共振小肠灌肠造影的适应症及选择,重点关注需要小肠磁共振成像和全身麻醉的患者:一项调查结果

Indications and selection of MR enterography vs. MR enteroclysis with emphasis on patients who need small bowel MRI and general anaesthesia: results of a survey.

作者信息

Torkzad Michael R, Masselli Gabriele, Halligan Steve, Oto Aytek, Neubauer Henning, Taylor Stuart, Gupta Arun, Frøkjær Jens Brøndum, Lawrance Ian C, Welman Christopher J, Negård Anne, Ekberg Olle, Patak Michael, Lauenstein Thomas

机构信息

Department of Radiology, Oncology, Radiation Sciences, Uppsala University, Uppsala, Sweden,

出版信息

Insights Imaging. 2015 Jun;6(3):339-46. doi: 10.1007/s13244-015-0384-2. Epub 2015 Apr 9.

Abstract

AIMS

To survey the perceived indications for magnetic resonance imaging of the small bowel (MRE) by experts, when MR enteroclysis (MREc) or MR enterography (MREg) may be chosen, and to determine how the approach to MRE is modified when general anaesthesia (GA) is required.

MATERIALS AND METHODS

Selected opinion leaders in MRE completed a questionnaire that included clinical indications (MREg or MREc), specifics regarding administration of enteral contrast, and how the technique is altered to accommodate GA.

RESULTS

Fourteen responded. Only the diagnosis and follow-up of Crohn's disease were considered by over 80 % as a valid MRE indication. The remaining indications ranged between 35.7 % for diagnosis of caeliac disease and unknown sources of gastrointestinal bleeding to 78.6 % for motility disorders. The majority chose MREg over MREc for all indications (from 100 % for follow-up of caeliac disease to 57.7 % for tumour diagnosis). Fifty per cent of responders had needed to consider MRE under GA. The most commonly recommended procedural change was MRI without enteral distention. Three had experience with intubation under GA (MREc modification).

CONCLUSION

Views were variable. Requests for MRE under GA are not uncommon. Presently most opinion leaders suggest standard abdominal MRI when GA is required.

MAIN MESSAGES

• Experts are using MRE for various indications. • Requests for MRE under general anaesthesia are not uncommon. • Some radiologists employ MREc under general anaesthesia; others do not distend the small bowel.

摘要

目的

调查专家对于小肠磁共振成像(MRE)的公认适应证,何时可选择磁共振小肠造影(MREc)或磁共振肠道造影(MREg),并确定在需要全身麻醉(GA)时MRE的检查方法如何调整。

材料与方法

挑选出的MRE领域意见领袖完成了一份问卷,内容包括临床适应证(MREg或MREc)、肠内造影剂给药细节以及如何调整技术以适应GA。

结果

14人做出回应。超过80%的人认为仅克罗恩病的诊断和随访是有效的MRE适应证。其余适应证的比例从乳糜泻诊断和不明原因胃肠道出血的35.7%到动力障碍的78.6%不等。对于所有适应证,大多数人选择MREg而非MREc(从乳糜泻随访的100%到肿瘤诊断的57.7%)。50%的受访者需要考虑在GA下进行MRE检查。最常推荐的检查方法改变是不进行肠管扩张的MRI检查。三人有在GA下插管的经验(MREc改良法)。

结论

观点存在差异。在GA下进行MRE检查的需求并不罕见。目前大多数意见领袖建议在需要GA时采用标准腹部MRI检查。

主要信息

• 专家将MRE用于各种适应证。• 在全身麻醉下进行MRE检查的需求并不罕见。• 一些放射科医生在全身麻醉下采用MREc;另一些则不进行小肠扩张。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d56/4444793/0d49182ae8dd/13244_2015_384_Fig1_HTML.jpg

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