MR Enterography is An Option for Children With Crohn's Disease

Children over the age of nine and who suffer from Crohn’s disease may benefit from MR enterography.

Children over the age of nine and who suffer from Crohn’s disease may benefit from MR enterography as a replacement for small bowel x-rays or CT enterography, finds a study.

Children with inflammatory bowel disease must often undergo repeated examinations, which, with x-rays and CT, could lead to significant radiation exposure, said William A. Faubion, Jr., MD, one of the authors of the study.

Crohn’s Disease
Crohn’s disease or regional enteritis is an inflammatory bowel disease that involves the small intestine and causes abdominal pain, diarrhea and bleeding.

"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," said Dr. Faubion.

The study—the largest North American study of its kind-- analyzed 70 pediatric patients who underwent MR enterography to review the quality of MR enterography images and to determine if pediatric patients could tolerate the examination.

The study, conducted at Mayo Clinic College of Medicine in Rochester, MN, found 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.

Ulcerative Colitis
Ulcerative colitis is characterized by bouts of diarrhea, bleeding per rectum and pain, which remits and relapses. Fulminant colitis is a possibility, which may require colectomy.

While a similar study using CT in children has not been performed, in adults MR and CT enterography have been found to be equivalent methods of small bowel imaging, said 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," Dr. Faubion said.

Small bowel atresia
The small bowel is the section of bowel between the stomach and the large bowel (colon). It is about 300cm long in a newborn baby at term and its function is to absorb food.

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, Dr. Faubion said.

Child Intusussception
Intussusception is condition where one segment of the intestine infolds into the adjacent segment causing intestinal blockage and leading to severe abdominal distension and pain.

Source-Eurekalert