MRI in IBD

Often when your Gastroenterologist orders imaging, CT scans may be the first recommended course for assessment of IBD, but according to the National Institute of Health, this is because of it’s widespread availability¹. Unfortunately, CT imaging is associated with significantly increased risk of radiation exposure making MRI’s a more appealing service to accurately assess inflammation in the patient’s bowels.

What is an MRI?

Per the NIH, an MRI is a “non-invasive imaging technology that produces 3D detailed anatomical images without the use of damaging radiation. It can be used to detect, diagnose and monitor different treatments in patients”¹.

How does it work?

When you are in an MRI machine, it may be loud. This is the sound of magnets producing a field that forces protons in the patient’s body to align with that field. A radio frequency current is then pulsed through the patient and the protons are stimulated, spin out of equilibrium and begin to straighten against the pull of the magnetic field. When the radio frequency field is turned off, the MRI sensors can detect the energy released as the protons realign with the magnetic field. From this, doctors are able to tell the difference between many types of tissues on the magnetic field properties.

What the heck does that all mean!?

Basically, when you go into that big magnetic, loud tube, radio frequency is used to pull your body’s “energy” into the machine to produce high-resolution images of the bowel to detect inflammation, wall thickening and any extra fluid in the area. Basically, MRIs are used more often than CTs because they reduce the radiation patients may be exposed to. Like CT scans, contrast agents may still be given intravenously before or during the procedure.

How do I prep for an MRI?

You do not need to do any prep for an MRI, but you may be asked to fast for a few hours before your imaging. You will likely need a pre-authorization for this type of test, so be sure to contact your insurance company and see if it will be covered by your plan.

During the MRI

You will wear ear protection that also allows you to communicate with the Radiology technicians during the test. The machine will be loud and you will feel vibrations of the MRI machine circulating your body. You may be instructed to take breaths, hold it and blow it out. You will repeat these steps several times. You’ll hear some clicking, some beeps and maybe even some music of your choice.

Follow Up

You will probably already have an appointment made to follow up with your Gastroenterologist or your Colorectal Surgeon to discuss the findings of your MRI. During the follow-up, your GI can discuss your findings, if your disease seems to be active or has moved further into your tract, but hopefully only good news.

Tell your radiologist if you are allergic to contrast, as Gadolinium can be used as a contrast in your IV. Other people with implants like a pacemaker or cochlear implants should tell their doctor before having your test, as this may prevent you from having certain types of imaging done.