Small Bowel X-Rays, CT Enterography May Be Replaced by MR Enterography for Children with Crohn Disease

Parents with children nine years old and older who have Crohn disease should ask their child’s physician about magnetic resonance (MR) enterography as a replacement for small bowel X-rays or computed tomography (CT) enterography, a new study revealed.

Children with inflammatory bowel disease must often undergo repeated examinations, which, with X-rays and CT, could lead to significant radiation exposure, reported William A. Faubion, Jr., MD, one of the authors of the study. “MR enterography does not require any radiation, however the patient does have to drink an oral contrast agent, must hold their breath at times and must limit their motion during the examination, all which can be difficult for pediatric patients,” stated Dr. Faubion.

The study, which is the largest North American study of its kind, examined 70 pediatric patients who underwent MR enterography to review the quality of MR enterography scans and to determine if pediatric patients could tolerate the examination. The study, performed at the Mayo Clinic College of Medicine (Rochester, MN, USA), discovered that “MR enterography performs as well in children as it does in adults. MR enterography could accurately identify inflammation 80% of the time in the terminal ileum, 79% of the time in the right colon and 90% of the time in the left colon,” said Dr. Faubion.

Whereas a similar study using CT in children has not been performed, in adults MR and CT enterography have been demonstrated to be similar methods of small bowel imaging, according to Dr. Faubion. “In addition, we found that MR enterography could be successfully completed in the majority of children nine years old and older, without having to sedate them,” he said. The number of patients who suffered side effects was low; two patients experienced nausea and one patient fainted, however, no ongoing care was required, he said. One patient refused to drink the contrast material. Tolerance to the procedure was related to the amount of contrast the patient had to drink; the study found that younger children could drink a smaller amount of contrast material without negatively affecting the MR enterography image quality, according to Dr. Faubion.

The study was published in the September 2012 issue of the American Journal of Roentgenology.

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