Lou Jingan, Lai Can, Chen Feibo, Chen Jie
Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
Zhonghua Er Ke Za Zhi. 2016 Jan;54(1):52-5. doi: 10.3760/cma.j.issn.0578-1310.2016.01.012.
To explore the value of magnetic resonance enterography (MRE) for diagnosis of small intestinal diseases in children.
A total of 92 children who received MRE from July 2009 to January 2014 were included into this study. The clinical value of MRE in children was evaluated by describing the image presentation of MRE based on clinical diagnosis.
All the 92 cases (average age was nine year and one month, among whom 61 were boys, and 31 were girls) received MRE examination with good tolerance and had no complications. Eleven cases (12%) did not show good distension of small bowel loop during MRE and could not evaluate the bowel wall pathologies correctly. A total of 66 cases (72%) showed pathological MRE images. All patients with Crohn's disease showed pathological gut and 53% (16/30) showed extramural changes with MRE, 97% (29/30) showed colon lesions with colonoscopy, 73% (20/22) showed small intestine lesions with capsule endoscopy. All patients with intestinal obstruction (7 cases) showed abnormal gut distension, 4 of whom showed obstruction point. Five patients with small intestinal neoplasms showed the mass with MRE. One of the patients with intestinal tuberculosis showed enlarged lymph nodes with ring strengthening. Nine cases with eosinophilic gastroenteritis (75%) and 1 case of gastrointestinal bleeding showed increased contrast enhancement for small bowel. The main finding of MRE were abnormal wall thickening and enhancement, gut stricture, bowel expansion, etc.
MRE for children was safe and reliable. It can be a suitable method for determining the location and extent of gut for small intestinal diseases, especially suitable for Crohn's disease in children.
探讨磁共振小肠造影（MRE）对儿童小肠疾病的诊断价值。
纳入2009年7月至2014年1月期间接受MRE检查的92例儿童。根据临床诊断描述MRE的图像表现，评估MRE在儿童中的临床价值。
92例患儿（平均年龄9岁1个月，其中男孩61例，女孩31例）均接受了MRE检查，耐受性良好，无并发症发生。11例（12%）在MRE检查期间小肠肠袢扩张不佳，无法正确评估肠壁病变。共有66例（72%）出现MRE病理图像。所有克罗恩病患儿均显示肠道病变，53%（16/30）的患儿MRE显示肠壁外改变，97%（29/30）的患儿结肠镜检查显示结肠病变，73%（20/22）的患儿胶囊内镜检查显示小肠病变。所有肠梗阻患儿（7例）均显示肠道扩张异常，其中4例显示梗阻点。5例小肠肿瘤患儿MRE显示肿块。1例肠结核患儿显示淋巴结肿大伴环形强化。9例嗜酸性胃肠炎患儿（75%）和1例胃肠道出血患儿显示小肠对比增强增加。MRE的主要表现为肠壁增厚、强化异常、肠道狭窄、肠管扩张等。
儿童MRE检查安全可靠。它可作为确定小肠疾病肠道位置和范围的合适方法，尤其适用于儿童克罗恩病。
