Use of MRI-Enema in the Assessment of Colorectal Anastomotic Integrity
Research type
Research Study
Full title
Comparison study of MRI-Enema and Water Soluble Contrast Enema in the Assessment of Colorectal Anastomotic Integrity Prior to Stoma Reversal.
IRAS ID
191029
Contact name
David Burling
Contact email
Sponsor organisation
LNWH Heathcare NHS trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
This study will compare two radiology techniques for detection of leaks from surgical anastomoses formed after excision of the rectum, usually for cancer or an inflammatory disorder.
The standard radiology method for detecting anastomotic leaks is by water-soluble contrast (dye) enema (WSCE) introduced per anus, followed by X-ray fluoroscopy to confirm contrast remains within the bowel and does not leak out into the pelvis. WSCE utilises ionising radiation and can be technically difficult to perform. In addition, WSCE provides limited information with no visualisation of the surrounding soft tissues of the pelvis such that 'contained' fluid collection cannot be seen. Standard MRI is therefore also undertaken in a proportion of patients when the radiology team suspect a fluid collection or leak not demonstrated by WSCE.
A new emerging MRI technique, ‘MRI-Enema’, may combine the advantages of WSCE and standard MRI for assessment of anastomotic integrity with fluid introduced into the rectum delineating small leaks whilst the cross-sectional imaging provides detailed analysis of the pelvis to reveal a collection.
Our hypothesis is that MRI-Enema will assess anastomotic integrity with similar accuracy to WSCE, with superior interpretative confidence amongst radiologists and the surgical team, whilst avoiding ionizing radiation and need for additional tests.
Eligible patients will be all those referred for WSCE to assess colorectal anastomotic integrity by colorectal surgeons, who have no MRI contraindications (eg. cardiac pacemaker). 19 patients would then undergo both examinations at a specialist imaging centre, ideally on the same day or a maximum of 7 days apart. The order of the two tests will be directed according to scan appointment availability. Each study would last approximately 30 minutes with no specific aftercare required.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
17/LO/0629
Date of REC Opinion
2 Jun 2017
REC opinion
Further Information Favourable Opinion