MR enterography - Impact on image quality between single- versus split-dose Buscopan.

ABSTRACT

INTRODUCTION: MR enterography (MRE) is the most common imaging modality used to assess small bowel pathology, particularly patients with suspected Crohn's disease. Spasmolytic agents, most commonly Buscopan, are routinely used to reduce or cease movement/bowel activity in order to reduce blurring of the images which would otherwise reduce its diagnostic quality. The purpose of this study was to determine if administering an evenly split dose of Buscopan would improve the quality of images obtained relative to the standard single dose performed at our institution. METHODS: Cine sequences through the anterior and mid-abdomen were performed to assess and document small bowel peristalsis. Additional analysis was performed by the use of digital subtraction and measuring the signal-to-noise ratio value on the subtracted image, which was used to compare the amount of small bowel movement. RESULTS: A total of 34 patients who presented to the Department of Medical Imaging between October 2018 and April 2019 were included. In the anterior section, those in the split-dose group had a mean difference of 2.4 lower number of peristalsing bowel loops compared to the single-dose group (P = 0.001), while in the mid-section, those in the split-dose group had a mean difference of 2.5 lower number of peristalsing bowel loops compared to the single-dose group (P-value = 0.001). CONCLUSION: Our findings indicate that split-dose Buscopan significantly reduced peristalsis compared to single-dose Buscopan, and a reduction in peristalsis reduces one aspect of motion artefact, which translates to better images.