Investigating the small bowel in pediatric Crohn's disease: Prospective comparative study between small intestine contrast ultrasonography and magnetic resonance imaging

2015 ◽  
Vol 47 ◽  
pp. e258
Author(s):  
F. Civitelli ◽  
F. Scelsa ◽  
M. Aloi ◽  
A. Dilillo ◽  
E. Casciani ◽  
...  
2018 ◽  
Vol 12 (6) ◽  
pp. 718-729 ◽  
Author(s):  
Mathilde Wagner ◽  
Huaibin Mabel Ko ◽  
Manjil Chatterji ◽  
Cecilia Besa ◽  
Joana Torres ◽  
...  

Abstract Background and Aims Recently, smooth muscle hypertrophy has been suggested to be a contributor to small bowel lesions secondary to Crohn’s disease [CD], in addition to inflammation and fibrosis. Here, we assess the value of magnetic resonance imaging [MRI] for the characterisation of histopathological tissue composition of small bowel CD, including inflammation, fibrosis, and smooth muscle hypertrophy. Methods A total of 35 consecutive patients [male/female 17/18, mean age 33 years] with ileal CD, who underwent small bowel resection and a preoperative contrast-enhanced MRI examination within 1 month before surgery, were retrospectively included. Image assessment included qualitative [pattern/degree of enhancement, presence of ulcerations/fistulas/abscesses] and quantitative parameters [wall thickness on T2/T1-weighted images [WI], enhancement ratios, apparent diffusion coefficient [ADC], Clermont and Magnetic Resonance Index of Activity [MaRIA] scores). MRI parameters were compared with histopathological findings including active inflammation, collagen deposition, and muscle hypertrophy using chi square/Fisher or Mann-Whitney tests and univariate/multivariate logistic/linear regression analyses. Results Forty ileal segments were analysed in 35 patients. Layered pattern at early-post-contrast phase was more prevalent (odds ratio [OR] = 8; p = 0.008), ADC was significantly lower [OR = 0.005; p = 0.022], and MaRIA score was significantly higher [OR = 1.125; p = 0.022] in inflammation grades 2–3 compared with grade 1. Wall thickness on T2WI was significantly increased [OR = 1.688; p = 0.043], and fistulas [OR = 14.5; p = 0.017] were more prevalent in segments with disproportionately increased muscle hypertrophy versus those with disproportionately increased fibrosis. MaRIA/Clermont scores, wall thickness on T1WI and T2WI, and ADC were all significantly correlated with degree of muscular hypertrophy. Conclusions MRI predicts the degree of inflammation, and can distinguish prominent muscle hypertrophy from prominent fibrosis in ileal CD with reasonable accuracy (area under receiver operating characteristic curve [AUROC] > 0.7).


2007 ◽  
Vol 133 (2) ◽  
pp. 385-390 ◽  
Author(s):  
Diego R. Martin ◽  
Thomas Lauenstein ◽  
Shanthi V. Sitaraman

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Rani Ahmad ◽  
Amr M. Ajlan ◽  
Ayman A. Eskander ◽  
Turki A. Alhazmi ◽  
Khalid Khashoggi ◽  
...  

Abstract Objectives Crohn’s disease (CD) is a condition that can occur in any part of the gastrointestinal tract, although usually forms in the colon and terminal ileum. Magnetic resonance imaging (MRI) has become a beneficial modality in the evaluation of small bowel activity. This study reports on a systematic review and meta-analysis of magnetic resonance enterography for the prediction of CD activity and evaluation of outcomes and possible complications. Methods Following the PRISMA guidelines, a total of 25 low-risk studies on established CD were selected, based on a QUADAS-II score of ≥ 9. Results A sensitivity of 90% was revealed in a pooled analysis of the 19 studies, with heterogeneity of χ2 = 81.83 and I2 of 80.3%. Also, a specificity of 89% was calculated, with heterogeneity of χ2 = 65.12 and I2 of 70.0%. Conclusion It was concluded that MRI provides an effective alternative to CT enterography in the detection of small bowel activity in CD patients under supervision of radiologist for assessment of disease activity and its complications. Its advantages include the avoidance of radiation exposure and good diagnostic accuracy.


2020 ◽  
Vol 46 (3) ◽  
pp. 4
Author(s):  
A. S. Sementsov ◽  
V. V. Ponomarenko

Abstract Purpose of the work is to show the possibilities of radiation diagnosis of the normal anatomy of the small and large intestine, as well as their pathological changes through the use of MRI (Hydro-MRI). Material and methods. Thirty patients were examined by the method of Hydro-MRI. All patients underwent magnetic resonance imaging on a device with a magnetic induction of 1.5T. To carry out Hydro-MRI, we used T2-weighted sequences, such as a one-time fast spin echo signal obtained in several planes, STIR sequences in three mutually perpendicular sequences, so that, edema wall can be estimated with additional diffusion-weighted images. Results. Twenty patients with the manifestations of Crohn's disease in the form of terminal ileitis, presence of interlope fistulous passages, paraproctitis (fistulous form) were detected. Colon tumors were detected in 8 patients, recurrence of gastrointestinal stromal tumor (GIST) of the small intestine in the anastomosis zone was detected in one patient, and no pathological changes were detected in one patient. Findings. Hydro-MRI allows visualizing the mass of the small, large intestine and determining the degree of invasion of the intestinal wall and surrounding tissues. Enterography using magnetic resonance enterography has become the most effective methods for visualizing the small intestine in patients with Crohn's disease and can visualize inflammation of the intramural or proximal small intestine in about 50% of patients with Crohn's disease who have undergone endoscopically normal studies. Hydro-MRI is indicated for Crohn's disease and for determining the degree of inflammatory activity. Recent evidence suggests that cross-section visualization may be useful in determining response to therapy, assessing bowel healing and monitoring disease progression. Also, according to researchers at the Medical Imaging Center, University College London, the quantitative motility of the small intestine is an objective biomarker of endoscopic and histopathological inflammatory activity in Crohn's disease and is comparable to previously confirmed estimates of MRI activity enhanced by gadolinium. The final ileal mobility indicator showed a good correlation with endoscopic and histopathological activity in Crohn's disease. The study is painless, no radiation load. Hydro-MRI is a method of choice, when it is impossible to conduct an X-ray examination of the intestine, the inability/uninformativeness of an endoscopic examination of the small, large intestine. Along with video capsular endoscopy, it allows visualization of all departments of the small and large intestine [1]. Keywords: Hydro-MRI or hydro-magnetic resonance imaging, Crohn's disease, small bowel and colon tumors.


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