CT vs. MRI enterography?

[twois]

Hey kids,

Had my appt with my GI on Wednesday and he's (understandably) concerned that I'm becoming more symptomatic as I wean off the prednisone. (As a matter of fact, I tapered to 30mg yesterday morning and by last night I was in pretty hardcore pain. Still am today. Guess who's getting a phone call first thing tomorrow morning?)

He wants to get some imaging done, and we discussed briefly a contract CT, which is what we ultimately decided to schedule, and an MRI enterography, which I was not at all familiar with and which he said he does not frequently schedule. His rationale for offering the MRI option was that I am a woman of childbearing age and imaging is something that I will likely end up doing with some regularity, so radiation exposure is something to think about; however, he said that the procedure for the MRI imaging involves oral intake of large volumes of fluid to provide a good look at the bowel and that patients tend to find it uncomfortable.

I can't find a lot about the MRI procedure - has anyone here been through it? I'm not terribly concerned about the CT radiation because I'm post-hysterectomy and am going to have to have a surrogate carry our kids anyways... they're gonna be IVF-ing those babies (pun intended) and picking and choosing the most viable ones anyways. But I'm curious about the enterography, both as a nursing student and a patient, since I'm just not familiar with it.

 

[DustyKat]

Matt had CT enterography done and he didn't find the prep to bad at all. He had to fast for 4 hours and then drink about 1500mls (I think) of a sugary tasting liquid over about an hour prior to scanning. He was allowed to void if needed so he was happy about that and they did also mention that it can cause diarrhoea so to let them know and you stop taking the prep, Matt didn't experience this. Apparently the prep is not absorbed by the small bowel, I think the additives coat the small bowel so that the water can't be absorbed, leaving the bowel distended and allowing far better images to be obtained.

HTH,
Dusty

 

[ThanksP]

I had the MRI(E) done recently. I did not have to drink HUGE quantities of barium, I'd say probably 12-14 ounces. It didn't taste nearly as bad as the old barium and it wasn't thick at all. From the MRE, the doc was able to see that my Crohn's had spread. I didn't find it uncomfortable at all except when the barium made it's way out of my body. But they do give you something at the end to stop bowel movement.

I'll NEVER do another CT scan if I can help it. Just ONE CT of the abdomen is equal to 500 chest XRays. And as my doc told me, they don't show nearly as much as the MRE does.
Seriously, it's a simple procedure compared to some of the other lovely tests us Crohnie's have to do.

 

[g_1988]

When you have your small bowel study you will need to drink a contrast agent starting 1 hour before you scan. You can drink it as quickly as you like and must drink at least 750ml for the scan to be effective. It doesn't taste very good, but if you've ever had a colonoscopy, it certainly isn't anything like the bowel prep for you take the day before. I think these drinks usually come sweetened but don't think it's going to be like fruit juice.

I have had a recent small bowel MRI and the procedure was that I enter face down and feet first, 1 hour after drinking the contrast agent. The radiographers performed quite a lot of scans, probably 1 every 2-3 minutes. Each time I had to take a deep breath in and hold for 20 or 30 seconds while the scan finished.

Doing that for 30 minutes wasn't very nice but certainly not uncomfortable or painful. I've never had any other type of scan so I can't compare, but it's not that bad really.

 

[ThanksP]

As far as the procedure, you drink two small bottles of barium, wait a few minutes, and then have an IV placed and go into the MRI machine. It's not very claustrophobic because your head and neck stick out. I had headphones on so I could listen to the radio. Occasionally the tech asks you to hold your breath for a few seconds. Towards the end, the nurse puts contrast into your IV and a few minutes later something to stop the movement of your bowels. Total time in the machine was probably an hour.

 

[twois]

Interesting! Good to know. I didn't realize the radiation dose was so much higher - yuck. I'll probably go ahead with the CT this time (assuming I can hold out two weeks for it with flaring back up as I taper the pred) but really consider the MRI(E) in the future.

Thanks, guys!