MRI of the small bowel with oral contrast or nasojejunal intubation in Crohn's disease: randomized comparison of patient acceptance.

OBJECTIVE: Magnetic resonance imaging of the small bowel with an oral contrast (MRI per os) is believed to generate fewer adverse symptoms compared with installation of the contrast in a nasojejunal catheter (MRE). However, there is very little evidence to support this assumption. The aim of this study was to evaluate the compliance of patients examined with both of these MRI methods.

MATERIAL AND METHODS: Patients with suspected or known Crohn's disease referred for MRI of the small bowel underwent both MRI per os and MRE within 7 days. A questionnaire was answered immediately and 24 h after the procedure. Adverse symptoms were graded on a visual analogue scale (VAS). Responses were compared with paired and independent sample t-tests and signed-rank tests. Correlation of each symptom to the overall discomfort was evaluated with Spearman's correlation coefficient.

RESULTS: Thirty-eight patients (18 F, 20 M) were included in the analysis. Abdominal pain and discomfort were lower with MRI per os than with MRE (mean VAS pain score immediately after: 10 mm and 33 mm, respectively, p < 0.001; mean VAS discomfort score 24 h after: 18 mm and 62 mm, respectively, p < 0.001). Nausea and abdominal pain were correlated with overall discomfort after MRI per os (r = 0.56 for both, p < 0.001). No symptoms were significantly correlated with discomfort experienced with MRE. More patients accepted repeat MRI per os examination (n = 36) than MRE (n = 22, p = 0.001).

CONCLUSION: Patients preferred and experienced less abdominal pain and discomfort with MRI per os than with MRE.