Entero RM

What is it?

Magnetic resonance enterography is a diagnostic examination that allows to study in detail the small intestine, an anatomical area difficult to evaluate by other methods both endoscopic and radiological. Thanks to the use of a neutral contrast medium delivered orally and a paramagnetic one injected intravenously, this examination allows to evaluate not only the intestinal lumen but also its wall with its various layers, vascularization, lymph nodes and mesentery.

It is a non-invasive examination as it uses the application of magnetic fields to obtain high quality images. Unlike CT, the patient is not exposed to the biological risk associated with ionizing radiation, resulting in a very safe examination. 

Among its limitations, it is less available on the area and a higher acquisition time of the images is to be considered.

When is this exam indicated?

This method allows to evaluate the presence of intestinal pathologies, both of inflammatory/infectious and neoplastic nature. In particular, it represents the examination of choice for the evaluation and follow-up of chronic inflammatory bowel diseases, such as Crohn's disease, allowing to define the degree of disease activity.  

Moreover, it is essential for videocapsulation, as it can identify any stenosis (narrowing) that may prevent its feasibility.

How is it performed?

There are no particular preparations required prior to the examination, with the exception of fasting which must be observed for at least 6 hours before. It is also required to take a blood sample for the dosage of creatinine in order to verify the normal functionality of the kidney.  

One hour before the start of the examination, the patient will be asked to drink a solution of water and polyethinylglycol (PEG), necessary as an oral contrast medium that can provide a good and complete distension of the intestinal loops with minimal side effects (diarrhea). A cannula is then inserted into the arm for subsequent administration of intravenous contrast agent. 

After removing all objects or clothing containing metal, the patient will be placed in a supine position on a couch positioned between the poles of the magnet. 

The examination lasts about 30 minutes and does not require any kind of assistance.

Contraindications

The absolute and relative contraindications can be distinguished.

Among the absolute contraindications are:

  • Presence of non-magnetically compatible pacemaker;
  • Presence of non-ferromagnetic metal bodies;
  • Body weight over 150 kg.

Instead, the relative contraindications are:

  • Presence of coronary stents on neck or urinary vessels, implanted within six weeks, (titanium stents are excluded). MR certification of compatibility is required for stents placed before 1995;
  • Presence of metal prostheses, clips (excluding titanium ones), heart valves, spinal distractors, neurostimulators, drug infusion pumps, unless a certification of compatibility with MR is obtained. 
  • Claustrophobia that may not allow the examination to be performed.

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