MRI Pouchography

  • Research type

    Research Study

  • Full title

    Pelvic Collections on MRI in Patients with Ileal Pouches, and a Feasibility Study of Dynamic MRI Enema and Defaecating MRI Pouchography

  • IRAS ID

    205599

  • Contact name

    Guy H T Worley

  • Contact email

    guy.worley@nhs.net

  • Sponsor organisation

    London North West Healthcare NHS Trust

  • Duration of Study in the UK

    1 years, 0 months, 0 days

  • Research summary

    Patients suffering from Ulcerative Colitis are treated medically if appropriate, but 1 in 4 undergo surgery to remove the colon and rectum, which is curative as this disease only affects the large bowel. In order to avoid a permanent stoma, the most popular solution is to create an ‘ileal pouch’. This involves folding the end of the remaining small bowel on itself in order to create a reservoir for stool, performing the job of the rectum previously. This procedure was invented at St Mark’s in 1978, and it is estimated that at least 10,000 patients now have a ‘pouch’ internationally.

    However, pouches are prone to problems, the most significant being ongoing infection in the pelvis because of leaks, inflammation of the pouch, and also problems emptying without an obvious anatomical cause. In total these problems affect around 1 in 3 patients with a pouch, and many of the difficult cases are referred to St Mark’s for local expertise.

    Studies previously undertaken at St Mark's demonstrate the fact that some current imaging investigations are lacking in value due 1) there not being a defined normal standard for the investigation (as with MRI scans of ileal pouches) and 2) the investigation not being sensitive enough to pick up the necessary signs (as with x-ray pouchography).

    The use of MRI enema studies in investigating ileal pouches has not previously been described. It is hypothesised that the use of static and moving MRI images of pouches will provide clinicians with greater detail than plain x-ray or CT images, and without the associated radiation dose.

  • REC name

    London - Chelsea Research Ethics Committee

  • REC reference

    16/LO/1785

  • Date of REC Opinion

    3 Nov 2016

  • REC opinion

    Further Information Favourable Opinion