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Logo of bmcmiBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Medical Imaging
 
BMC Med Imaging. 2012; 12: 3.
Published online Feb 15, 2012. doi:  10.1186/1471-2342-12-3
PMCID: PMC3313890
Small bowel enteroclysis with magnetic resonance imaging and computed tomography in patients with failed and uncertain passage of a patency capsule
Frans-Thomas Fork,corresponding author1 Nils Karlsson,2 Sattar Kadhem,3 and Bodil Ohlsson4
1Department of Clinical Sciences Malmö, Medical Radiology, Diagnostic Centre of Imaging and Functional Medicine, Skåne University Hospital, SE-20502 Malmö, Sweden
2Medical School at Lund University, BMC Studentcentrum, Se-221 84 Lund, Sweden
3Department of Clinical Sciences Lund, Medical Radiology, Skåne University Hospital, SE-221 85 Lund, Sweden
4Department of Clinical Sciences Malmö, Division of Gastroenterology, Skåne University Hospital, SE-20502 Malmö, Sweden
corresponding authorCorresponding author.
Frans-Thomas Fork: thomas.fork/at/med.lu.se; Nils Karlsson: nils.karlsson.23/at/gmail.com; Sattar Kadhem: sattar1967/at/hotmail.com; Bodil Ohlsson: bodil.ohlsson/at/med.lu.se
Received May 26, 2011; Accepted February 15, 2012.
Abstract
Background
Video capsule enteroscopy (VCE) has revolutionized small bowel imaging, enabling visual examination of the mucosa of the entire small bowel, while MR enteroclysis (MRE) and CT enteroclysis (CTE) have largely replaced conventional barium enteroclysis. A new indication for MRE and CTE is the clinical suspicion of small bowel strictures, as indicated by delayed or non-delivery of a test capsule given before a VCE examination, to exclude stenosis. The aim of this study was to determine the clinical value of subsequent MRE and CTE in patients in whom a test capsule did not present itself in due time.
Methods
Seventy-five consecutive patients were identified with a delayed or unnoticed delivery of the test capsule. Seventy patients consented to participate and underwent MRE (44) or CTE (26). The medical records and imaging studies were retrospectively reviewed and symptoms, laboratory results and imaging findings recorded.
Results
Lesions compatible with Crohns disease were shown by MRE in 5 patients, by CTE in one and by VCE in four, one of whom had lesions on MRE. In patients without alarm symptoms and findings (weight loss, haematochezia, anaemia, nocturnal diarrheoa, ileus, fistula, abscess and abnormal blood tests) imaging studies did not unveil any such lesion. VCE's were performed in only 20 patients, mainly younger than 50 years of age, although no stenotic lesion was shown by MRE and CTE. In the remaining 50 patients no VCE or other endoscopic intervention was performed indicating that the referring physician was content with the diagnostic information from MRE or CTE.
Conclusion
The diagnostic value of MRE and CTE is sufficient for clinical management of most patients with suspected small bowel disease, and thus VCE may be omitted or at least postponed for later usage.
Keywords: Small bowel, enteroclysis, magnetic resonance imaging, computed tomography, patency capsule, video capsule enteroscopy
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