MR imaging

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Digital Subtraction Dark-Lumen MR Colonography For Lesion Detection – Initial Experience

Journal Title, Volume, Page: 
Proc. Intl. Soc. Mag. Reson. Med. 11 (2004)
Year of Publication: 
2004
Authors: 
C. U. Herborn
Dept. of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany
W. M. Ajaj
University Hospital Essen, Essen, Germany
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
T. C. Lauenstein
University Hospital Essen, Essen, Germany
S. Massing
University Hospital Essen, Essen, Germany
S. G. Ruehm
University Hospital Essen, Essen, Germany
Preferred Abstract (Original): 

Dark-lumen MR colonography combining a water enema with intravenous contrast administration is a rapidly evolving, minimally invasive method of evaluating the entire colon (1-2). Results of several preliminary series indicate that this technique has a high sensitivity for detection of colorectal cancer and significant polyp lesions as well as inflammatory disease of the bowel (3). Since bowel movements are depressed during the examination a digital subtraction technique comparable to vascular studies might be applicable and facilitate detection of regions with increased contrast uptake

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Oral Contrast Agents For Small Bowel Distension In MRI: Influence of The Osmolarity For Small Bowel Distention

Journal Title, Volume, Page: 
European Radiology (2005) Volume: 15, Issue: 7, Pages: 1400-1406
Year of Publication: 
2005
Authors: 
Waleed Ajaj
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Mathias Goyen
Medical Center Hamburg-Eppendorf, Hamburg, Germany
Hubert Schneemann
Institute of Pharmacy and Pharmaceutical Sciences University Hospital Essen, Essen, Germany
Christiane Kuehle
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
Michael Nuefer
Department of Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
Stefan G. Ruehm
Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Susanne C. Goehde
Department of Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
Thomas C. Lauenstein
Department of Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
Preferred Abstract (Original): 

To assess the effect of the osmolarity for small bowel distension in MRI, ten volunteers ingested at two separate occasions negative oral contrast agents with different quantity and osmolarity: (1) a water solution combined with 2.0% sorbitol and 0.2% locus bean gum (LBG) with a quantity of 1500 ml and an osmolarity of 148 mOsmol/l, (2) a water solution combined with 2.0% sorbitol and 2.0% barium sulphate with a quantity of 1000 ml and an osmolarity of 194 mOsmol/l. Small bowel distension was quantified on coronal 2D-TrueFISP images by measuring the small bowel diameters. There were no statistically significant differences in mean small bowel diameter between both contrast agents. The mean small bowel distension was 19.2 mm after ingestion of 1500 ml of sorbitol-LBG solution and 19.0 mm after ingestion of 1000-ml sorbitol-barium sulphate solution. Furthermore, all volunteers found the ingestion of 1000-ml solution more pleasant than the 1500-ml solution. The ingestion of 1000 ml of sorbitol-barium sulphate solution led to a sufficient small bowel distension compared to 1500 ml of sorbitol-LBG solution. The side effect rate of both solutions was low. Based on these data, we recommend a quantity of 1000 ml of sorbitol-barium sulphate solution as an alternative for 1500-ml sorbitol-LBG solution for optimal bowel distension.

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Combined Small And Large Bowel MR Imaging In Patients With Crohn’s Disease: A Feasibility Study

Journal Title, Volume, Page: 
Eur Radiol (2004) 14:1535–1542
Year of Publication: 
2004
Authors: 
Burcu Narin
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
Waleed Ajaj
Dept. Diagn./Interventional Radiol., University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Susanne Göhde
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
Jost Langhorst
Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
Haldun Akgöz
Dr Siyami Ersek Hastanesi, Istanbul, Turkey
Guido Gerken
Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
Stefan G. Rühm
Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, USA
Thomas C. Lauenstein
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
Preferred Abstract (Original): 

MRI of the small bowel is a new method for the assessment of inflammatory bowel diseases. However, inflammatory bowel disease can affect both the small and large bowel. Therefore, our goal was to assess the feasibility of displaying the small bowel and colon simultaneously by MR imaging. Eighteen patients with inflammatory bowel disease were studied. For small bowel distension, patients ingested a solution containing mannitol and locust bean gum. Furthermore, the colon was rectally filled with water. MR examinations were performed on a 1.5-T system. Before and after intravenous gadolinium administration, a T1w data set was collected. All patients underwent conventional colonoscopy as a standard of reference. The oral ingestion and the rectal application of water allowed an assessment of the small bowel and colon in all patients. By means of MRI (endoscopy), 19 (13) inflamed bowel segments in the colon and terminal ileum were detected. Furthermore, eight additional inflammatory lesions in the jejunum and proximal ileum that had not been endoscopically accessible were found by MRI. The simultaneous display of the small and large bowel by MRI is feasible. Major advantages of the proposed MR concept are related to its non-invasive character as well as to the potential to visualize parts of the small bowel that cannot be reached by endoscopy.

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Dark Lumen Mr Colonography: Can High Spatial Resolution Vibe Imaging Improve The Detection of Colorectal Masses

Journal Title, Volume, Page: 
Fortschr Rontgenstr 2006; 178: 1073–1078
Year of Publication: 
2006
Authors: 
Waleed Ajaj
Medical Center, University Hospital Hamburg-Eppendorf
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
S. G. Ruhm
Department of Radiology, David Geffen School of Medicine
N. Papanikolaou
Department of Radiology, University Hospital of Heraklion
T. C. Lauenstein
Department of Radiology, Emory Clinic
G. Gerken
Klinik fur Gastroenterologie und Hepatologie, Universitatsklinikum Essen
M. Goyen
Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Essen
Preferred Abstract (Original): 

Purpose: To assess whether the detection of colorectal lesions can be improved using high spatial resolution VIBE imaging.
Materials and Methods: 48 patients underwent same-day dark lumen MR colonography (MRC) and conventional colonoscopy (CC) as the standard for the detection of colorectal masses. MRC was performed using contrast-enhanced standard and high spatial resolution T1-weighted 3D VIBE sequences. The findings and the image quality of the standard and high spatial resolution VIBE sequences were compared qualitatively and quantitatively. The findings of both sequences regarding colorectal lesions were compared to those of a subsequently performed colonoscopy.
Results: The high spatial resolution VIBE sequence significantly improved the quantitative image quality (CNR 54.0 vs. 36.8). However, high spatial resolution VIBE imaging did not detect more colorectal lesions than the standard VIBE sequence. In addition, none of the sequences employed was able to detect lesions with a diameter of less than 5mm (CC 40 lesions). However, 13 colorectal lesions with a diameter of greater than 5mm were detected by both sequences (CC 15).
Conclusion: High spatial resolution VIBE imaging did not improve the detection of colorectal masses and MRC fails to detect colorectal lesions with a diameter of less than 5 mm.

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