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Review Article| Volume 13, ISSUE 2, P331-348, May 2005

Small Bowel

      MR imaging of the small bowel has been an unexplored field of application for several years—often confined to advanced and selected research centers—without any real clinical impact. The first experimental studies were published in 1985 [
      • Runge V.M.
      • Foster M.A.
      • Clanton J.A.
      • et al.
      Particulate oral NMR contrast agents.
      ,
      • Wesbey G.E.
      • Brasch R.C.
      • Goldberg H.I.
      • et al.
      Dilute oral iron solutions as gastrointestinal contrast agents for magnetic resonance imaging; initial clinical experience.
      ] followed by a limited number of contributions until 1997 [
      • Hahn P.F.
      • Stark D.D.
      • Saini S.
      • et al.
      Ferrite particles for bowel contrast in MR imaging: design issues and feasibility studies.
      ,
      • Widder D.J.
      • Edelman R.R.
      • Grief W.L.
      • et al.
      Magnetite albumin suspension: a superparamagnetic oral MR contrast agent.
      ,
      • Laniado M.
      • Kornmesser W.
      • Hamm B.
      • et al.
      MR imaging of the gastrointestinal tract: value of Gd-DTPA.
      ,
      • Bisset III, G.S.
      Evaluation of potential practical oral contrast agents for pediatric magnetic resonance imaging. Preliminary observations.
      ,
      • Lonnemark M.
      • Hemmingsson A.
      • Bach-Gansmo T.
      • et al.
      Effect of superparamagnetic particles as oral contrast medium at magnetic resonance imaging. A phase I clinical study.
      ,
      • Li K.C.
      • Ang P.G.
      • Tart R.P.
      • et al.
      Paramagnetic oil emulsions as oral magnetic resonance imaging contrast agents.
      ,
      • Hahn P.F.
      • Stark D.D.
      • Lewis J.M.
      • et al.
      First clinical trial of a new superparamagnetic iron oxide for use as an oral gastrointestinal contrast agent in MR imaging.
      ,
      • Tart R.P.
      • Li K.C.
      • Storm B.L.
      • et al.
      Enteric MRI contrast agents: comparative study of five potential agents in humans.
      ,
      • Rubin D.L.
      • Muller H.H.
      • Young S.W.
      Methods for the systematic investigation of gastrointestinal contrast media for MRI: evaluation of intestinal distribution by radiographic monitoring.
      ,
      • Li K.C.
      • Tart R.P.
      • Fitzsimmons J.R.
      • et al.
      Barium sulphate suspension as a negative oral MRI contrast agent: in vitro and human optimization studies.
      ,
      • Ros P.R.
      • Steinman R.M.
      • Torres G.M.
      • et al.
      The value of barium as a gastrointestinal contrast agent in MR imaging: a comparison study in normal volunteers.
      ,
      • Patten R.M.
      • Moss A.A.
      • Fenton T.A.
      • et al.
      OMR, a positive bowel contrast agent for abdominal and pelvic MR imaging: safety and imaging characteristics.
      ,
      • Van Beers B.
      • Grandin C.
      • Jamart J.
      • et al.
      Magnetic resonance imaging of lower abdominal and pelvic lesions: assessment of oral magnetic particles as an intestinal contrast agent.
      ,
      • Mirowitz S.A.
      • Susman N.
      Use of nutritional support formula as a gastrointestinal contrast agent for MRI.
      ,
      • Chou C.K.
      • Liu G.C.
      • Chen L.T.
      • et al.
      The use of MRI in bowel obstruction.
      ,
      • Hirohashi S.
      • Uchida H.
      • Yoshikawa K.
      • et al.
      Large scale clinical evaluation of bowel contrast agent containing ferric ammonium citrate in MRI.
      ,
      • Anderson C.M.
      • Brown J.J.
      • Balfe D.M.
      • et al.
      MR imaging of Crohn disease: use of perflubron as a gastrointestinal contrast agent.
      ,
      • Bernardino M.E.
      • Weinreb J.C.
      • Mitchell D.G.
      • et al.
      Safety and optimum concentration of a manganese chloride-based oral MR contrast agent.
      ,
      • Haldemann Heusler R.C.
      • Wight E.
      • Marincek B.
      Oral superparamagnetic contrast agent (ferumoxsil): tolerance and efficacy in MR imaging of gynaecologic diseases.
      ,
      • Rollandi G.A.
      • Martinoli C.
      • Conzi R.
      • et al.
      Magnetic resonance imaging of the small intestine and colon in Crohn's disease.
      ,
      • Van Beers B.E.
      • Grandin C.
      • De Greef D.
      • et al.
      Ferristene as intestinal MR contrast agent. Distribution and safety of a fast ingestion procedure with oral metoclopramide.
      ,
      • Semelka R.C.
      • John G.
      • Kelekis N.L.
      • et al.
      Small bowel neoplastic disease: demonstration by MRI.
      ,
      • Madsen S.M.
      • Thomsen H.S.
      • Munkholm P.
      • et al.
      Magnetic resonance imaging of Crohn disease: early recognition of treatment response and relapse.
      ,
      • Faber S.C.
      • Stehling M.K.
      • Holzknecht N.
      • et al.
      Pathologic conditions in the small bowel: findings at fat-suppressed gadolinium-enhanced MR imaging with an optimized suspension of oral magnetic particles.
      ,
      • Aschoff A.J.
      • Zeitler H.
      • Merkle E.M.
      • et al.
      MR enteroclysis for nuclear spin tomographic diagnosis of inflammatory bowel diseases with contrast enhancement.
      ,
      • Paley M.R.
      • Ros P.R.
      MRI of the gastrointestinal tract.
      ]. It was only in 1998 that the number of publications started to increase (Fig. 1) [
      • Ernst O.
      • Asselah T.
      • Cablan X.
      • et al.
      Breath-hold fast spin-echo MR imaging of Crohn's disease.
      ,
      • Rieber A.
      • Wruk D.
      • Nussle K.
      • et al.
      MRI of the abdomen combined with enteroclysis in Crohn disease using oral and intravenous Gd-DTPA.
      ,
      • Holzknecht N.
      • Helmberger T.
      • von Ritter C.
      • et al.
      MRI of the small intestine with rapid MRI sequences in Crohn disease after enteroclysis with oral iron particles.
      ,
      • Ha H.K.
      • Lee E.H.
      • Lim C.H.
      • et al.
      Application of MRI for small intestinal diseases.
      ,
      • Lee J.K.
      • Marcos H.B.
      • Semelka R.C.
      MR imaging of the small bowel using the HASTE sequence.
      ,
      • Regan F.
      • Beall D.P.
      • Bohlman M.E.
      • et al.
      Fast MR imaging and the detection of small-bowel obstruction.
      ]. The reason was not lack of interest, but the technical inadequacy of MR scanners to perform motion-free examinations. Developments in hardware (gradients, multichannel coils) and software (fast and ultrafast sequences) enabled breath-held studies, reezing voluntary (respiratory) and involuntary (peristaltic) motion artifacts [
      • Lee J.K.
      • Marcos H.B.
      • Semelka R.C.
      MR imaging of the small bowel using the HASTE sequence.
      ,
      • Regan F.
      • Beall D.P.
      • Bohlman M.E.
      • et al.
      Fast MR imaging and the detection of small-bowel obstruction.
      ], and opening the access to modern abdominal MR imaging.
      Figure thumbnail gr1
      Fig. 1The exponential growth in the number of publications on small bowel magnetic resonance imaging from 1985 to 2004. (Source: Medline; Keywords: small bowel, MT imaging.)
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