SERIAL OBSERVATIONS IN CROHNS-DISEASE - C AN HYDRO-MRI REPLACE FOLLOW-THROUGH EXAMINATIONS

Purpose: To compare the value of hydro-MRI with follow-through examina tions in the follow-up of Crohn's disease. Method: 22 patients known t o be suffering from Crohn's disease were examined via 1.5 T-MR system; an oral contrast examination using 1000 ml of a 2.5% mannitol solutio n was performed in all patients. T-2-weighted TSE sequences and T-1-we ighted SE sequences were performed before and after the intravenous in jection of Gd-DTPA. To reduce movement artifacts caused by peristalsis of the gut, intravenous injection of 40 mg Buscopan was given. The fi ndings of hydro-MRI were compared with the follow-through examinations . Results: In the upper gastrointestinal tract, the follow-through exa mination showed clear advantages compared with hydro-MRI for the demon stration of inflammatory changes in the gut; Hydro-MRI was, however, s omewhat more reliable in the ileum and colon. It was also more sensiti ve than the follow-through for the demonstration of enteric fistulae ( four as compared with two cases), and in demonstration extraluminal ch anges (free fluid in six against zero, and inflammatory adherent loops (four against zero)). Amongst the 22 patients, hydro-MRI was equal (i n 10) or better (in 8) than the follow-through examination for demonst rating the intestinal manifestations of Crohn's disease, and follow-th rough was better in only four. Conclusion: For follow-up of Crohn's di sease, hydro-MRI is at least as good as follow-through examination, an d is even preferable, because of the absence of radiation exposure of the usually young patients.