777 The Use of Mr Enterography in Children with Crohn's Disease

BACKGROUD: Ionizing techniques are frequently used in the evaluation of disease activity in children affected by inflammatory bowel disease (IBD). Magnetic Resonance enterography (MRE) is an interesting new imaging modality avoiding ionizing radiation and the discomfort aβociated with enteroclysis. Methods: After fasting for at least 4 hours, bowel distention was achieved by ingesting 1 liter of a 2,5% mannitol solution. MRI was performed with a 1,5 T system (Philips Achieva) and a phased-array torso-XL coil. The examination was completed with administration of an IV spasmolyticum. During the examination 1 MR-technician provided patient support. Results: 5 children (2 girls), aged 12.3 + 1.6 years, underwent a MRE. 4/5 were newly diagnosed patients. The exam was well tolerated in all children. The MRsequences were taken in 10-15 min. Overall image quality was good with sufficient bowel distension in the jejunum and excellent distension of the ileum. 1 patient (12,4y) had difficulties with breath-hold resulting in motion artefacts; the examination was however of diagnostic quality. MRI enterography revealed lesions of jejunum, preterminal or terminal ileum, caecum and rectosigmoideum in resp. 1, 2, 5, 1 and 1 patient. MR could detect lesions such as bowel wall thickening and oedema, deep ulceration, pseudo-diverticula, hyper-enhancement of bowel wall, stranding of fat, comb-sign, separation of bowel loops and reactive lymph nodes. No fistula or absceβ were visualised in these patients. Conclusions: MR enterography is a promising ionizing sparing technique for the evaluation of small and large bowel disease extent in children with Crohn's disease.