Small bowel MRI enteroclysis or follow through: which is optimal?

Aim: To determine if a nasojejunal tube (NJT) is required for optimal examination of enteroclysis and if patients can be examined only in the supine position.
Methods: Data were collected from all patients undergoing small bowel (SB) magnetic resonance imaging (MRI) examination over a 32-mo period. Patients either underwent a magnetic resonance (MR) follow-through (MRFT) or a MR enteroclysis (MRE) in the supine position. The quality of proximal and distal SB distension as well as the presence of motion artefact and image quality were assessed by 2 radiologists.
Results: One hundred and fourteen MR studies were undertaken (MRFT-49, MRE-65) in 108 patients in the supine position only. Image artefact was more frequent in MRE than in MRFT (29.2% vs 18.4%), but was not statistically significant (P=0.30). Adequate distension of the distal SB was obtained in 97.8% of MRFT examinations and in 95.4% of MRE examinations, respectively. Proximal SB distension was, however, less frequently optimal in MRFT than in MRE (P=0.0036), particularly in patients over the age of 50 years (P=0.0099). Image quality was good in all examinations.
Conclusion: All patients could be successfully imaged in the supine position. MRE and MRFT are equivalent for distal SB distension and artefact effects. Proximal SB distension is frequently less optimal in MRFT than in MRE. MRE is, therefore, the preferred MR examination method of the SB.