RadteraMR Enterography (MRE) With and Without Contrast
MR+ ContrastAbdomen & Pelvis
Indications
- Crohn disease (diagnosis, disease activity, complications)
- Small bowel inflammation / stricture / fistula
- Treatment response monitoring
- Suspected small bowel tumor
Patient prep
- NPO ~4-6 hours
- Oral biphasic contrast (e.g., ~1-1.5 L of mannitol/PEG or VoLumen) over ~45-60 min before scan to distend small bowel
- IV antiperistaltic (glucagon or hyoscine) to reduce bowel motion
- IV access for gadolinium; MRI safety screening; body coil
Contrast
Agentgadolinium-based (IV) plus oral biphasic luminal agent
RouteIV (gadolinium) + oral (luminal)
DoseGadolinium 0.1 mmol/kg IV
TimingEnteric (~45-60 s) and delayed (~70 s / 7 min) post-contrast fat-sat 3D T1
Technique
- Adequate luminal distension is essential—oral contrast titrated before scan
- Antiperistaltic agent minimizes motion (often split dose before SSFP and before post-contrast)
- Breath-hold SSFP (FIESTA/TrueFISP) and single-shot T2 (HASTE) in axial and coronal
- Cine SSFP to assess peristalsis/strictures; DWI for inflammation; dynamic post-contrast
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Cor SSFP (FIESTA/TrueFISP) | coronal | bSSFP | 4-5 mm | Bowel overview, wall, mesentery |
| 2 | Ax SSFP | axial | bSSFP | 4-5 mm | |
| 3 | Cor/Ax single-shot T2 (HASTE) | coronal/axial | T2 | 4-5 mm | With and without fat-sat; wall edema = activity |
| 4 | Cine SSFP | coronal | bSSFP cine | thick slab | Peristalsis, fixed vs functional stricture |
| 5 | Ax DWI/ADC | axial | DWI | 5 mm | Active inflammation |
| 6 | Ax/Cor 3D T1 fat-sat pre | axial/coronal | T1 FS | 3-4 mm | Baseline |
| 7 | Ax/Cor 3D T1 fat-sat post (enteric + delayed) | axial/coronal | T1 FS +C | 3-4 mm | Mural hyperenhancement, fistula |
Key points
- Bowel distension and antiperistaltic agent are the keys to a diagnostic MRE.
- Signs of active Crohn: mural hyperenhancement, wall thickening, T2/DWI hyperintensity, comb sign.
- Cine SSFP distinguishes fixed stricture from transient peristaltic narrowing.
- Evaluate for penetrating complications: fistula, sinus tract, abscess.
- No ionizing radiation—favored for young patients needing repeated monitoring.
References
• ACR-SAR-SPR Practice Parameter / SAR-AGA Recommendations for MR Enterography
• Radiopaedia: MR enterography protocol link
• RadioGraphics: MR Enterography in Crohn Disease
• Radiopaedia: MR enterography protocol link
• RadioGraphics: MR Enterography in Crohn Disease
Source: Researched — verify against your institution
‹ PreviousCT Urogram (Hematuria; Multiphase)Next ›MRI Abdomen / Liver With and Without Contrast + MRCP
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.