China
Africa
Explore chapters and articles related to this topic
Effects of treatment on the abdomen and pelvis
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
MR enteroclysis has a similar sensitivity to conventional enteroclysis for detection of small bowel strictures; however, nasoenteric intubation causes patient discomfort, involves logistical difficulties, and necessitates exposure to radiation. MR enterography is preferred to MR enteroclysis because it is easier, takes less time, is better tolerated, and does not involve irradiation. Although predominantly used for Crohn's disease, it has the advantage of demonstrating early treatment-related inflammatory changes (Figure 39.16), the extent of bowel wall thickening, fistulae, and excluding any associated mass lesion. It is useful when multiple follow-up imaging examinations are needed as there is no irradiation (38).
Gastrointestinal tract and salivary glands
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Small bowel MRI has become a routine, safe and widely used technique for investigations of the small intestine. It has replaced the conventional small bowel meal examination in many centres and is the method of choice for imaging the small bowel in an increasing number of situations. MR enterography involving the simple drinking of preparation agents is the normal routine and generally good small bowel distension is achieved by these methods, with improved patient tolerance compared with entercloysis where contrast is introduced using a NG tube. Enterography achieves excellent soft tissue resolution and mural and extramural enteric depiction. MR allows multiplanar imaging and avoids the use of ionising radiation, which is a key factor for sequential follow-up imaging for young patients [31; 32).
The Small Intestine
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Computed tomography (CT) scans with oral contrast are widely used in the investigation of abdominal symptoms and can demonstrate fistulae, intra-abdominal abscesses and bowel thickening or dilatation. Magnetic resonance imaging (MRI) is useful in assessing complex perianal disease and, more recently, has been shown to be an excellent method for investigating the small bowel. MR enterography (oral contrast) or enteroclysis (contrast administered via nasoduodenal tube) is particularly effective at demonstrating small bowel stricturing and avoids the need for repeated exposure to large doses of ionising radiation in young patients (Figure69.4). A labelled white cell scan is occasionally of value to determine whether or not a segment of bowel is actively inflamed and guide decisions on medical treatment.
New magnetic resonance imaging sequences for fibrosis assessment in Crohn’s disease: a pilot study
Published in Scandinavian Journal of Gastroenterology, 2022
Bénédicte Caron, Valérie Laurent, Freddy Odille, Silvio Danese, Gabriela Hossu, Laurent Peyrin-Biroulet
All the imaging studies were performed on a 1.5 T MR scanner (MAGNETOM Avantofit, Siemens Healthcare, Erlangen, Germany). The same MR enterography protocol was used in all patients prior MRI examination: patients were prepared and were asked to drink one liter of mannitol preparation 45 min before the MR examination, and 0.5 mg of glucagon was injected just before the contrast agent was injected (Clariscan – GE Healthcare SAS, or Dotarem – Guerbet France). Axial and coronal breath-hold T2-weighted using half-Fourier-acquired single-shot turbo spin Echo (HASTE) and as well as axial and coronal steady state gradient echo (TRUEFISP). Free-breathing axial diffusion weighted imaging was acquired using single-shot echo-planar imaging. Axial and coronal 3D T1-weighted images were acquired using volume interpolated breath-hold technique (VIBE). The VIBE sequence was repeated before and 40 s (arterial), 80 s (portal phase), and the delayed phases at 3 min, and 7 min after contrast agent injection.
Pigmented paravenous chorioretinal atrophy revealing a chronic granulomatous disease
Published in Ophthalmic Genetics, 2019
Vasily M. Smirnov, Delphine Ley, Brigitte Nelken, Florence Petit, Sabine Defoort-Dhellemmes
At follow-up visits, the child complained of abdominal pain, diarrhea, unexplained fever, and oral ulcers, associated with weight loss and perianal abscess, and fistula. Abdominal ultrasonography and colonoscopy revealed severe pancolitis with mucosal aphthous ulcers. Microscopic analysis of colonic biopsies showed acute colitis with non-caseating granuloma. Crohn’s-like inflammatory bowel disease was suspected and the child was treated with infliximab and azathioprine. However, the intestinal disease was complicated by colonic perforation with parasigmoid abscess formation. MR enterography revealed a diffuse mesenteric infiltration and lymphadenopathy, and this was the reason that the patient was screened for immune dysfunction. Nitro blue tetrazolium test (NBT) result was 0%. Homozygous mutation was found in the NCF1 gene (c.75_76delGT in exon 2), confirming the diagnosis of recessive chronic granulomatous disease (CGD).
Cronkhite-Canada syndrome: a retrospective analysis of four cases at a single medical center
Published in Scandinavian Journal of Gastroenterology, 2022
Xing Yu, Chengdang Wang, Mi Wang, Yinchen Wu, Linlin Zhang, Qinyu Yang, Long Chen
Multiple polyps are an important feature of CCS and can be distributed throughout the digestive tract, most commonly in the stomach and colon, followed by the small intestine, and least commonly in the esophagus [5]. In our group, gastric and colonic polyps were found in all the four patients with CCS, and the polyps were mostly diffusely distributed, tuberous, or granular with different sizes. To date, reports of CCS have focused on gastric and colonic lesions, with less attention paid to small-bowel lesions. However, CCS may also affect the small intestine. Owing to the special anatomical location and complex structure of the small intestine, it is difficult to diagnose and evaluate CCS intestinal lesions. At present, intestinal lesions of CCS are mainly detected using capsule endoscopy, double-balloon enteroscopy, and gastrointestinal contrast. However, invasive endoscopic evaluation, such as double-balloon enteroscopy and capsule endoscopy may be limited by bowel strictures, and techniques require special equipment and expertise, whereas gastrointestinal contrast involves radiation. Recently, magnetic resonance (MR) enterography has been increasingly used for the evaluation of small intestinal diseases. As a non-invasive and non-radiological technique, the cross-sectional imaging can clearly detect small intestinal lesions in Crohn's disease [25]; its application has also been well described in the Peutz-Jeghers syndrome [26]. In our study, small intestinal lesions were found in three patients using MR enterography, and the main manifestations were as follows: diffuse wall thickening, high signal intensity on DWI, obvious enhancement, and multiple small nodular enhancements of the small intestine. Therefore, MR enterography can be used to detect small-intestinal lesions in CCS. However, these findings do not seem to be well differentiated from those of other inflammatory intestinal diseases. Fast imaging with steady-state precession and gadolinium-enhanced fat-suppressed volumetric interpolated breath-hold examination are the most useful MR imaging sequences for detecting small bowel polyps [27]. However, further research is required.