MRI of normal and abnormal duodenum using half-Fourier single-shot rare and gadolinium-enhanced spoiled gradient echo sequences

The objective of this research was two fold: First, to describe the normal and abnormal MR appearances of the duodenum using combined Half-Fourier Acq uisition Single Shot RARE (HASTE) and gadolinium-enhanced standard and fat suppressed spoiled gradient echo (SGE) sequences. The second objective was to assess the ability of these combined sequences to detect and characteriz e duodenal diseases. MR examinations were performed on fifty consecutive pa tients with no clinical history of duodenal diseases, who were 1) imaged wi th HASTE and gadolinium-enhanced standard and fat suppressed SGE sequences and 2) referred to MR examination for reasons other than duodenal diseases, and were reviewed retrospectively to determine the normal MR appearances o f the duodenum. A second population of patients with abnormal duodenum who were imaged with the same MR sequences were included in the second part of this study. This population was composed of 20 consecutive patients with su bsequently proven duodenal abnormalities, including: malrotation (2), diver ticula (4), intussusception (1), sprue (1), polyps (2), neurofibroma (1), l ymphoma (1), Zollinger Ellison syndrome (1), metastatic disease (1), Crohn' s disease (1), and wall thickening and duodenitis (5). Normal measurements of the duodenum are described. Abnormalities of wall thickness and duodenal masses required combined HASTE and gadolinium-enhanced SGE images to evalu ate well. Abnormalities of the bowel lumen (e.g., diverticula and intussusc eption), and developmental variants (e.g., malrotation), were sufficiently visualized on HASTE images alone. Bowel inflammation was best shown on gado linium-enhanced fat suppressed SGE images. HASTE and gadolinium-enhanced fa t suppressed SGE sequences are complementary techniques for the demonstrati on of normal and abnormal duodenum. The combined use of both sequences allo ws evaluation of different aspects of bowel diseases; abnormalities of posi tion, lumen, and contents are well shown on HASTE, while inflammation is be st shown on gadolinium enhanced fat suppressed SGE, and wall thickening and masses are best evaluated with the combined use of both techniques. (C) 19 99 Elsevier Science Inc.