So E's doctor wants him to have an MRI now. He just had a colonoscopy, endoscopy, biopsies, etc done. Is this normal? Just curious 
Mri
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I don't really know about the contrast fluids. I guess I should have asked more questions :ybatty:
I think he said something about getting a baseline for possible damage he couldn't view with the scope? I could be completely wrong on that though.
The MRI can image the entire small intestines (and other organs too) - something that the endoscopy and colonoscopy cannot. Just ot prepare your child and yourself, worth asking if the MRI would involve drinking contrast (which makes it an MRE). Whne we were told my son would have an MRI, we were told he did not need to drink any contrast, so we ate dinner right before. (Fasting is recommended at most places) It turned out he needed to drink 3 large shakes of thick contrast. We ended up staying in the hospital from ~6PM to 4AM waiting for the contrast to go threw his intestines.
Thank you dannysmom. This is good to know. I will definitely ask more questions so we know what to expect and how to prep.
He said he preferred it over a CT because it is "zero" radiation. Do you think he meant MRE instead of MRI?
Dannysmom ~ this is the first time I ever really read your signature...they thought Danny had CF? Oh my! I bet that was super scary for you!?!
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yes, to all the above - scopes cannot get into the small intestine so an MRE will give images of that area.
No radiation compared to CT.
And, you do want an MRE not an MRI (probably what the GI is suggesting). MRE includes fasting, drinking a contrast plus an IV (at least in our experience), I believe an MRI is the IV only.
My son has felt a bit nauseated and has a bit of diarrhea after an MRE but both pass fairly quickly.
No radiation compared to CT.
And, you do want an MRE not an MRI (probably what the GI is suggesting). MRE includes fasting, drinking a contrast plus an IV (at least in our experience), I believe an MRI is the IV only.
My son has felt a bit nauseated and has a bit of diarrhea after an MRE but both pass fairly quickly.
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Pretty standard after dx DS had a ct but later an MRE since our hospital was able to do them for cd at that point.
MRE has replaced the small bowel follow through as the best way to rule out severe small bowel problems. MRE, CT and pill cam are the only way to image the small bowel. Ct has radiation of up to 500 xrays. Pill cam is OK but has several draw backs including that it can get stuck and require emergency surgery to remove it. Also it only images what the camera is pointed at so if the camera isn't pointed at the ulcer it doesn't "see" it.
Regarding the MRI/MRE, in addition to the info you've already gotten I would say
1. you want to have the MRE done someplace that does them regularly if possible. If you have any doubt about the number of pediatric MRE's the imaging center has done I would call them and ask. You may have to ask to speak to a radiologist to get the info you want.
2. MRE's require placement of an IV port for access. This is where they inject the medication for the 2nd half of the test. There is no IV equipment like a pole or bag, just the port in his arm that's taped down and should not hurt once it's placed.
Children's hospitals usually have several "good" tasting options for the contrast fluid.
My adult sister had an MRE at Mayo Clinic and they just gave her water. Made me wonder about all these other places...
Regarding the MRI/MRE, in addition to the info you've already gotten I would say
1. you want to have the MRE done someplace that does them regularly if possible. If you have any doubt about the number of pediatric MRE's the imaging center has done I would call them and ask. You may have to ask to speak to a radiologist to get the info you want.
MRE's require a radiologist with special training and the techs need training to conduct the study correctly. It has two parts. The first part is the regular imaging. The second part they give a dose of medication that stimulates peristalsis so they can image changes associated with that. This can help discriminate between scar tissue and inflammation for example.
2. MRE's require placement of an IV port for access. This is where they inject the medication for the 2nd half of the test. There is no IV equipment like a pole or bag, just the port in his arm that's taped down and should not hurt once it's placed.
Children's hospitals usually have several "good" tasting options for the contrast fluid.
My adult sister had an MRE at Mayo Clinic and they just gave her water. Made me wonder about all these other places...
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Nothing medical is ever totally benign, but an MRI, even with contrast, is not too bad. In my opinion, more imaging is always better. It's nice to have a nice robust record and history to refer back to if things start to go sideways and you wonder when it started. The potential for catching problems that were potentially missed by other tests is another pro.
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Where's Kermit??
And the gun???:eek2:
Where's Kermit??
And the gun???:eek2:
It's, um, a very nice tie muppet.
I have duly documented it.
I think you should consider changing your moniker to Fuzzy Wuzzy.
I have duly documented it.
I think you should consider changing your moniker to Fuzzy Wuzzy.
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Just to chime in and agree with what others said since my son just went through this. The MRI complements the endoscopy/colonoscopy since those scopes can't reach the small intestine. We tried a patency capsule to see if a pill-camera would pass without trouble with strictures, but it wasn't conclusive whether it did (came out >24 hours and xray of location wasn't very clear), so we went MRI. Or MRE, docs seem to call it both and I think MRE just means MRI with both drink contrast and IV contrast. When he was dx 2 years ago, they did an upper GI flouroscopy, kind of like a video-x-ray of drinking contrast. It was the coolest thing to watch, but they don't seem to order now. probably because it's lots of radiation where an MRI uses magnets. It's a pain to go through the contrast drink and IV, but the procedure itself in the tube is the easy/relaxing part.
DustyKat
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Nothing to add to the info re the need for imaging to visualise the small bowel.
The difference with an enterograph (MRE) as opposed to an MRI is the oral contrast used. The contrast used in an enterograph is a sugary based substance that is designed to line the wall of the bowel as opposed to being absorbed by it.
Although not an MRE one of the radiology places we went to never gave anything but water when doing CT's on Matt. The hospitals always used gastrografin.
Dusty. xxx
The difference with an enterograph (MRE) as opposed to an MRI is the oral contrast used. The contrast used in an enterograph is a sugary based substance that is designed to line the wall of the bowel as opposed to being absorbed by it.
Although not an MRE one of the radiology places we went to never gave anything but water when doing CT's on Matt. The hospitals always used gastrografin.
Dusty. xxx
It may have been because of my sister's particular situation. She has severe short bowel and cannot tolerate concentrated amounts of sugar and a huge long list of other things. So maybe there wasn't any contrast medium they felt she could tolerate. Hadn't thought of that before now.
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Just some tips for the MRE... and someone please correct me if I'm off on some things...
My son was 11 when he had his first MRE and drinking three glasses of the contrast was tough. They do flavor it for kids, but after awhile it just tastes yucky. We had a Child Life person working with us and we just let him drink as much as he could initially. After that we watched a clock and at the 45 mark, she'd have him drink for 10 seconds. Then could take a break, walk a few laps around the receptionists desk (to get the contrast moving in his system) and then come back. It would be close to the 45 mark again and he'd repeat. Try to make a game out of it if you can with distractions and little challenges. Make him walk backwards one time or do the lap on a rolling chair. This is a tough age where they don't necessarily want to be treated like a little kid with distractions, yet they still kind of need it.
In the end my son only managed two of the three glasses but by then he was in tears and super nauseous so they let him stop. The results weren't ideal since he didn't get enough contrast in.
While doing the actual MRE, even though he was allowed headphones to listen to music, he had to be very active. Hold your breathe, move this way, exhale, hold your breathe. It was quite the work out and took a good hour. He was exhausted afterward.
Last, be sure to have him drink lots and lots and lots of water afterward to flush the contrast out of his system. He may be nauseous or have a stomach ache for a bit, but keep pushing the water. It's very important to get the contrast flushed out.
Let us know how things turn out and good luck!
My son was 11 when he had his first MRE and drinking three glasses of the contrast was tough. They do flavor it for kids, but after awhile it just tastes yucky. We had a Child Life person working with us and we just let him drink as much as he could initially. After that we watched a clock and at the 45 mark, she'd have him drink for 10 seconds. Then could take a break, walk a few laps around the receptionists desk (to get the contrast moving in his system) and then come back. It would be close to the 45 mark again and he'd repeat. Try to make a game out of it if you can with distractions and little challenges. Make him walk backwards one time or do the lap on a rolling chair. This is a tough age where they don't necessarily want to be treated like a little kid with distractions, yet they still kind of need it.
In the end my son only managed two of the three glasses but by then he was in tears and super nauseous so they let him stop. The results weren't ideal since he didn't get enough contrast in.
While doing the actual MRE, even though he was allowed headphones to listen to music, he had to be very active. Hold your breathe, move this way, exhale, hold your breathe. It was quite the work out and took a good hour. He was exhausted afterward.
Last, be sure to have him drink lots and lots and lots of water afterward to flush the contrast out of his system. He may be nauseous or have a stomach ache for a bit, but keep pushing the water. It's very important to get the contrast flushed out.
Let us know how things turn out and good luck!
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Thanks Dusty and Mehita! The drink Alex had was sugary. He was supposed to drink 2 full bottles in 2 hours, but they were fine that he nearly finished 1 in that time and he was starting to get nauseous. It wasn't at all like the chalky white stuff he did year before last with his MRI.
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The place I went to does water and the what call glue like substance
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MRI is Magnetic Reasonance Imaging. MR is an abreviation for MRI (as CT is an abbreviation for CAT scan); MR enterography is simply MRI of the intestines (enterography=The anatomical description of the intestines). (CT enterography also exists).
Generally speaking the soft tissues of the intestines are undifferentiated from each other and need some form of contrast to be seen. (I am guessing water is better than nothing in cases where contrast is not indicated). Oral contrast fills/distends the inside of the colon and gadolinium (the injected "contrast") is used to differentiate further the actual soft tissue. Another medication (glucagon, I think) may be used to slow motility (peristalsis) for less bowel movement during the long scans.
Izz was NPO in the am, got an IV inserted, drank 2 large cups of contrast (she had to run to the restroom shortly after). We waited a little bit, had one set of scans (on her belly with her head partially out of the machine), was injected, ran more scans, and was done. The actual scans were about 30 minutes with LONG breath holds.
We went to the hospital I work at. It was the first MRE done there, but the MRI supervisor researched it fully and discussed the case with the radiologist before giving me the go-ahead. Her peds GI said it was better then the scans he gets from the larger childrens hospital near his office. So I guess sometimes it pays to be the first (they also assured me that if the scan was of poor quality they wouldn't charge us so were we free to get it repeated elsewhere. I was fairly confident, given his research, that it was seriously unlikely).
Generally speaking the soft tissues of the intestines are undifferentiated from each other and need some form of contrast to be seen. (I am guessing water is better than nothing in cases where contrast is not indicated). Oral contrast fills/distends the inside of the colon and gadolinium (the injected "contrast") is used to differentiate further the actual soft tissue. Another medication (glucagon, I think) may be used to slow motility (peristalsis) for less bowel movement during the long scans.
Izz was NPO in the am, got an IV inserted, drank 2 large cups of contrast (she had to run to the restroom shortly after). We waited a little bit, had one set of scans (on her belly with her head partially out of the machine), was injected, ran more scans, and was done.
The actual scans were about 30 minutes with LONG breath holds. We went to the hospital I work at. It was the first MRE done there, but the MRI supervisor researched it fully and discussed the case with the radiologist before giving me the go-ahead. Her peds GI said it was better then the scans he gets from the larger childrens hospital near his office. So I guess sometimes it pays to be the first (they also assured me that if the scan was of poor quality they wouldn't charge us so were we free to get it repeated elsewhere. I was fairly confident, given his research, that it was seriously unlikely).
