AJR:180, January 2003 191
Original Report
OBJECTIVE. The purpose of our report is to describe morphologic abnormalities of the
small bowel in a population of patients with known celiac disease using MR imaging with
polyethylene glycol solution as an oral contrast agent.
CONCLUSION. Polyethylene glycol–enhanced MR imaging is a noninvasive (no ioniz-
ing radiation is used), feasible, and reproducible imaging technique in both adult and pediatric
populations. Findings on polyethylene glycol–enhanced MR imaging, similar to those of con-
ventional barium studies, may suggest a diagnosis of celiac disease because the technique can
not only reveal intestinal involvement but also show extraintestinal findings.
eliac disease is a gluten-sensitive
enteropathy of the gastrointesti-
nal tract that affects the small in-
testine in genetically susceptible individuals.
It was previously thought to be a disease of
childhood, but now adult presentation is in-
creasingly common, and the disease can oc-
cur at any age [1]. Although small-intestine
biopsy is mandatory to confirm a diagnosis
suspected by means of clinical grounds and
serologic markers [2], an accurate radiologic
examination is important not only for recog-
nition of small-bowel abnormalities but also
to document normal morphology before bi-
opsy. A radiologic examination also helps to
exclude complicating lesions, including in-
tussusception, jejunal ulceration with stric-
ture, lymphoma, or carcinoma, in patients
presenting with abdominal pain [2].
Traditionally, a small-bowel follow-through
examination has been used to document ra-
diologic abnormalities [3]; CT findings of ce-
liac disease have also been described [4, 5].
More recently, MR imaging has been advo-
cated as a possible diagnostic method for im-
aging of the small bowel because of its
excellent soft-tissue contrast and multiplanar
imaging capabilities. MR evaluation of the
small bowel may be performed through dif-
ferent technical approaches by distending the
small bowel with either positive or negative
contrast agents. In our experience, bowel dis-
tention can be obtained using a recently re-
ported technique [6] based on the ingestion of
a polyethylene glycol isosmotic and nonab-
sorbable solution as an oral contrast agent.
The aim of our study was to assess the fea-
sibility of polyethylene glycol–enhanced MR
imaging in the evaluation of morphologic ab-
normalities of the small bowel in a population
of patients with known celiac disease.
Subjects and Methods
Patient Population
Between January and December 2001, we pro-
spectively investigated 27 patients: 17 adults (seven
women, 10 men; age range, 20–54 years; mean
Andrea Laghi
1
Pasquale Paolantonio
1
Carlo Catalano
1
Lucia Dito
2
Iacopo Carbone
1
Maria Barbato
2
Ernesto Tomei
1
Roberto Passariello
1
Received April 3, 2002; accepted after revision
June 19, 2002.
1
Department of Radiology, University of Rome “La
Sapienza,” Policlinico Umberto I, Viale Regina Elena 324,
00161 Rome, Italy. Address correspondence to A. Laghi.
2
Department of Pediatrics, University of Rome
“La Sapienza,” 00161 Rome, Italy.
AJR 2003;180:191–194
0361–803X/03/1801–191
© American Roentgen Ray Society
C
MR Imaging of the Small Bowel
Using Polyethylene Glycol Solution
as an Oral Contrast Agent in Adults
and Children with Celiac Disease:
Preliminary Observations
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