Background Information:

What are the other Names for the Procedure?

• Magnetic Resonance Enterography
• MRI of Small Intestine
• MRE (Magnetic Resonance Enterography)

What is MR Enterography radiology procedure? (General Explanation)

• MR Enterography is a specific type of MRI procedure, which is used to take detailed images of the small intestine
• Magnetic resonance imaging (MRI) is a noninvasive medical test that uses a powerful magnetic field to produce images of soft tissues, bones, organs, and all other internal body structures. An MRI does not use any radiation for visualizing the body parts

What part of the Body does the Procedure involve?

The abdominal region (small intestine) is involved in an MR Enterography procedure.

Why is the MR Enterography radiology procedure Performed?

An MR Enterography is performed to evaluate and diagnose various conditions, such as:

• Bowel obstructions
• Abdominal pain
• Intestinal tumors
• Bleeding sources of intestine
• Inflammation
• Presence of Crohn’s disease or inflammatory bowel disease
• Abscess
• Fistulas

What is the Equipment used? (Description of Equipment)

The equipment used for Magnetic Resonance Enterography is the following:

• An MRI is a large cylinder-shaped tube that is surrounded by a circular magnet
• The patient lies on the table that slides back and forth in the cylinder tube
• In some MRI equipment, called short-bore systems, the magnet does not completely surround the patient. This is particularly helpful for patients who are obese, or those fearful of being in a closed tube. This is called an open MRI

What are the Recent Advances in the Procedure?

There have been no recent advances in the field of Magnetic Resonance Enterography procedure.

What is the Cost of performing the MR Enterography radiology procedure?

The cost of an MR Enterography procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding MR Enterography procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.nlm.nih.gov/medlineplus/ency/article/003335.htm (accessed on 10/15/14)

Prior to MR Enterography radiology procedure:

How does the MR Enterography radiology procedure work?

• The MRI equipment uses magnet fields instead of ionizing radiation
• An electrical current passes through coils in order to produce a magnetic field
• Other coils send and receive radio waves and signals that are detected by the coils
• A computer processes the signals and generates images showing a thin slice of the body part

How is the MR Enterography radiology procedure Performed?

The MR Enterography procedure is performed as follows:

• The patient is positioned on the moveable examination table
• The respiratory gating belt is placed on the patient’s upper abdomen, to see how the patient is breathing during the imaging
• The patient may be given a contrast material through IV, if required
• The patient has to remain still during the procedure, in order to avoid any blurriness of the images
• The patient is moved into the MRI unit and images are taken, while the radiologist is checking the images in another room
• If the patient is required to have MR spectroscopy, which provides additional information on the chemicals present in the body’s cells; then, the procedure may take an additional 15 minutes

Where is the Procedure Performed?

An MR Enterography is performed either as an outpatient or inpatient procedure, at a hospital.

Who Performs the Procedure?

The procedure is performed by a radiology technologist, under the supervision of a radiologist.

How long will the Procedure take?

The MR Enterography procedure usually takes about 30-60 minutes.

Who interprets the Result?

A radiologist interprets the results of the MR Enterography procedure and informs the primary care physician.

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a MR Enterography procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
• Women should notify the physician, if they are pregnant or breastfeeding their child; as many such procedures may not be performed on pregnant women
• Depending on the procedure adopted, the patient may be asked for certain bowel or bladder preparations, before the preparation sessions
• The patient may be asked to avoid eating or drinking, several hours before the test
• It is recommended to notify the physician about any implants or metal objects in the body, such as a pacemaker, nerve simulators, surgical staples, or artificial heart valves, braces, or dyed tattoos, as they may interfere with the imaging, in some cases
• Those with metal objects in their body may be required to have an X-ray taken, before the MRI scan. In many cases, having a metal object in the body is a contraindication for performing an MRI scan

What is the Consent Process before the Procedure?

• A physician will request your consent for MR Enterography procedure using an Informed Consent Form
• Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent
• You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of an MR Enterography procedure:

• The MRI procedure does not use any ionizing radiation
• The contrast material used in MRI is less likely to produce an allergic reaction, than such contrast materials used in other procedures
• The MRI imaging tool can also be used as a guidance tool for performing biopsies
• It is a non-invasive technique
• The MRI helps determine the organ structure and how functional they are
• This method can also detect abnormalities, which are obscured by bones

Following are the risks of an MR Enterography procedure:

• Generally, patients undergoing an MRI procedure have almost no risks associated with the procedure
• The MRI uses a strong magnetic field, which can affect medically-implanted metal devices
• The patient may experience an allergic reaction, due to the contrast material used in the procedure; though, this is very rare
• There is a very rare chance of developing nephrogenic systemic fibrosis, if high doses of gadolinium contrast material are used in patients with very poor kidney function
• There is a chance of excessive sedation, if sedation is used in the procedure 

What are the Limitations of the MR Enterography radiology Procedure?

Following are the limitations of an MR Enterography procedure:

• The MRI scan is quite expensive and takes more procedure performing time, than other imaging techniques
• The patient must remain still, in order to obtain high-quality images through the scan
• MRI scans take longer than other procedures and require keeping life-support equipment away from the machine. Thus, it is not used in acutely injured patients and in emergency situations
• In some cases, obese or large patients may have a difficulty in bodily-fitting into a conventional MRI machine
• Pregnant women are usually advised against having an MRI exam, unless it is deemed absolutely necessary

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is an MR Enterography procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Enterography radiology procedure:

What is to be expected during the MR Enterography radiology procedure?

The MR Enterography is a painless procedure.

• The table you lie on may feel hard and the room may be cool
• The patient may find it uncomfortable to stay still for a long time
• If the patient is claustrophobic (fear of being in closed spaces), sedation may be used to help the patient to relax
• The patient may hear tapping or thumping sounds, when images are taken and may relax between the imaging sequences. If the patient wants to avoid the machine noise, they may request ear plugs
• Some people feel nervous inside the MRI scanner, due to the noise of the equipment; this is quite normal
• The patient is usually alone in the scan room during an MRI procedure, but the technologist will be able to see, hear, and speak, to the patient during the procedure
• The patient may feel a little warm on the part of the body, where images are taken
• A cooling and flushing sensation may be felt for a few minutes, when the contrast material is injected. Very rarely, the patient may feel nauseous, due to the contrast material
• Recovery period is not necessary for patients, who are not sedated. These patients may resume their normal activities immediately after the exam

What kind of Anesthesia is given, during the Procedure?

Anesthesia is rarely used during an MR Enterography procedure.

How much Blood will you lose, during the Procedure?

Since the procedure is minimally-invasive, the blood loss involved during the procedure is minimal.

What are the possible Risks and Complications during the MR Enterography radiology procedure?

Generally, the patient undergoing the procedure has almost no risks associated with it. However, the following risks are possible during the MR Enterography procedure:

• The MRI uses a strong magnetic field, which may affect any metal, medically-implanted devices in the body
• The patient may experience an allergic reaction, due to the contrast material used in the procedure; but this is very rare
• There is a very rare chance of developing nephrogenic systemic fibrosis, if high doses of gadolinium contrast material are used in patients, with very poor kidney function
• There is a chance of excessive sedation, if sedation is used in the procedure

What Post-Operative Care is needed at the Healthcare Facility after the MR Enterography radiology procedure?

No specific post-operative care is needed at the healthcare facility after the procedure. 

After the MR Enterography radiology procedure:

What is to be expected after the MR Enterography radiology procedure?

Generally, no complications or side effects are observed after a Magnetic Resonance Enterography procedure.

• No recovery period is necessary for patients, who are not sedated. These patients may resume their normal activities and diet, immediately after the exam
• Very rarely, the patient may feel nauseous, due to the contrast material used in the procedure
• If the patient is allergic to the contrast material, he/she may in rare cases experience hives, itchy eyes, or local pain. In these cases, doctors are available for immediate assistance

When do you need to call your Physician?

If the patient is experiencing an allergic reaction from the contrast reaction, then do contact the physician immediately.

What Post-Operative Care is needed at Home after the MR Enterography radiology procedure?

No specific post-operative care is needed at home after the procedure.

How long does it normally take to fully recover, from the Procedure?

The patient needs no recovery time after the MR Enterography procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The MR Enterography procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the MR Enterography radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the MR Enterography procedure is performed.