Abstract
Technical guidelines for magnetic resonance imaging (MRI) of the small bowel (SB) in the setting of inflammatory bowel diseases (IBDs) were detailed in a 2017 consensus issued by European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Pediatric Radiology (ESPR); however, MRI for non-IBD conditions was not addressed. Hence, we performed a systematic review collecting researches on SB MRI for non-IBDs. The literatures were then divided into morphologic group and functional group. Information about the MRI techniques, gastrointestinal preparation, and details of cine-MRI protocols was extracted. We found that a 1.5 T MRI system, prone positioning, and MR enterography were frequently utilized in clinical practice. Gadolinium contrast sequences were routinely implemented, while diffusion-weighted imaging (DWI) was much less performed. The gastrointestinal preparation varied throughout the studies. No uniform protocols for cine imaging could be established. SB MRI examinations for non-IBDs are far from standardized, especially for functional studies. Recommendations for standard parameters in cine-MRI sequences are difficult to make due to lack of evidentiary support. MRI investigations in non-IBD conditions are needed and the standardization of non-IBD imaging in clinical practice is required.
Highlights
With the transition toward quantitative imaging and greater demand for multi-center cooperation, medical image standardization has become increasingly important
A systematic search for studies focusing on small bowel magnetic resonance imaging (MRI) exclusive of inflammatory bowel diseases (IBDs) published from January 2008 to December 2018 was performed
The sample size examined in both articles was approximately around 30 for both groups (Fig. 2)
Summary
With the transition toward quantitative imaging and greater demand for multi-center cooperation, medical image standardization has become increasingly important. The morphological group included studies investigating organic small bowel abnormalities and the functional group consisted of those focused on intestinal function. Ten of the fifteen studies in functional group utilized cine-MRI to assess the small bowel function (Table 2). 96% of the studies distended the small SB before MRI acquisition with enteric contrast.
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