3D Modeling and Virtual Endoscopy of the Small Bowel Based on Magnetic Resonance Imaging in Patients With Inflammatory Bowel Disease

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Abstract
Schreyer A, Herfarth H, Kikinis R, et al. 3D modeling and virtual endoscopy of the small bowel based on magnetic resonance imaging in patients with inflammatory bowel disease. Invest Radiol 2002;37:528–533. Rationale and Objectives. Small bowel MRI (MR imaging) is a new imaging modality that excellently depicts small intestine pathology in patients with inflammatory bowel disease. Virtual endoscopy based on sectional imaging is a recently introduced technique to create endoscopy like views. The aim of this study was to evaluate the feasibility of virtual small bowel endoscopy based on MR imaging in patients with Crohn disease. Materials and Methods. Thirty consecutive patients with Crohn disease were scanned after oral application of pineapple juice for contrasting the small bowel. Dedicated high resolution T1 weighted 3D-FLASH sequences with fat suppression were used for volume scanning. Volume-rendered 3D models of the small bowel were created and virtual endoscopy was performed. The feasibility and quality of this new visualization method was assessed. Results. In nine of 30 patients virtual endoscopy was considered as good quality (flight through the entire small bowel was possible, typical folds were revealed). In 18 patients fair quality (at least 4/5 of the small bowel were depicted adequately) was assessed. In three of 30 patients virtual endoscopy was not sufficiently possible because of inadequate bowel filling or breathing artifacts. Three fistulae diagnosed on 2D MRI were visualized on the virtual endoscopic view. Conclusion. Virtual endoscopy of the small bowel is feasible based on high resolution MR imaging. Vivid insight views and 3D models provide an interesting addition to sectional MR findings.