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MR enterography

Zehour AlSabban, Peter Church, Rahim Moineddin, Oscar M Navarro, Mary-Louise Greer, Thomas Walters, Govind B Chavhan
PURPOSE: To determine interobserver agreement (IOA) and accuracy of conventional MR enterography (MRE), qualitative diffusion, and apparent diffusion coefficient (ADC) values for detecting clinically active inflammation. METHODS: MREs in 57 consecutive children with suspected inflammatory bowel disease were retrospectively reviewed. RESULTS: Substantial IOA for conventional MRE (kappa=0.65) and qualitative diffusion (kappa=0.64), but fair to good IOA for ADC, (intra-class coefficient=0...
September 28, 2016: Clinical Imaging
So Hyun Park, Jimi Huh, Seong Ho Park, Seung Soo Lee, Ah Young Kim, Suk-Kyun Yang
OBJECTIVES: To prospectively investigate how Buscopan affects the diagnosis of bowel inflammation by diffusion-weighted imaging MR enterography (DWI-MRE) in Crohn's disease (CD). METHODS: Thirty CD patients without previous bowel surgery underwent DWI-MRE (b = 900 sec/mm(2)) before and after intravenous Buscopan. The 30 patients were randomly divided into two groups; using a crossover design, interpretations were made regarding the presence of restricted mural diffusion (i...
October 5, 2016: European Radiology
Daniel G Rosenbaum, Maire A Conrad, David M Biko, Eduardo D Ruchelli, Judith R Kelsen, Sudha A Anupindi
BACKGROUND: Imaging predictors for surgery in children with Crohn disease are lacking. OBJECTIVE: To identify imaging features of the terminal ileum on short-interval bowel ultrasound (US) and MR enterography (MRE) in children with Crohn disease requiring surgical bowel resection and those managed by medical therapy alone. MATERIALS AND METHODS: This retrospective study evaluated patients 18 years and younger with Crohn disease undergoing short-interval bowel US and MRE (within 2 months of one another), as well as subsequent ileocecectomy or endoscopy within 3 months of imaging...
September 29, 2016: Pediatric Radiology
Antoine Brouquet, Anne-Sophie Rangheard, Jonathan Ifergan, Thierry Lazure, Franck Carbonnel, Christophe Penna, Stéphane Benoist
AIM: The study aimed to evaluate the accuracy of imaging for the measurement of the length of the ileocolic segment affected by Crohn's disease. METHOD: Fifty-four consecutive patients who underwent resection between 2011 and 2014 for ileocolic Crohn's disease were prospectively studied. All had preoperative magnetic resonance (MR) or computed tomographic (CT) enterography. Two independent radiologists measured the length of the diseased intestinal segment. The measurements were compared with the length of disease assessed on pathology of the non-fixed surgical specimen...
September 8, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Uri Kopylov, Eyal Klang, Doron Yablecovitch, Adi Lahat, Benjamin Avidan, Sandra Neuman, Nina Levhar, Tomer Greener, Noa Rozendorn, Arkadi Beytelman, Henit Yanai, Iris Dotan, Yehuda Chowers, Batya Weiss, Shomron Ben-Horin, Marianne M Amitai, Rami Eliakim
BACKGROUND: Video capsule endoscopy (VCE) and magnetic resonance enterography (MRE) are the prime modalities for the evaluation of small bowel (SB) Crohn's disease (CD). Mucosal inflammation on VCE is quantified using the Lewis score (LS). Diffusion-weighted (DW) magnetic resonance imaging (MRI) allows for accurate assessment of SB inflammation without administration of intravenous contrast material. The Magnetic Resonance Index of Activity (MaRiA) and the Clermont index are quantitative activity indices validated for contrast-enhanced MRE and DW-MRE, respectively...
September 2016: Therapeutic Advances in Gastroenterology
Andrew H Schapiro, Tom K Lin, Jason S Frischer, Ayaka Silverman, Andrew T Trout
Extensive heterotopic gastric mucosa of the small intestine is a rare, but potentially life-threatening condition characterized by multifocal or long-segment heterotopic gastric mucosa within the bowel lumen that is often associated with other anomalies including malrotation and annular pancreas. Although the imaging findings are characteristic, this entity may be unrecognized due to its unusual imaging appearance and rarity. CT or MR enterography and (99m)Tc-sodium pertechnetate scintigraphy can provide complementary information that enables specific diagnosis and accurate assessment of disease extent...
August 29, 2016: Pediatric Radiology
D A Pendsé, J C Makanyanga, A A Plumb, G Bhatnagar, D Atkinson, Manuel Rodriguez-Justo, S Halligan, S A Taylor
PURPOSE: To evaluate whether the extent of enteric diffusion-weighted imaging (DWI) signal abnormality reflects inflammatory burden in Crohn's disease (CD), and to compare qualitative and quantitative grading. METHODS: 69 CD patients (35 male, age 16-78) undergoing MR enterography with DWI (MRE-D) and the same-day faecal calprotectin (cohort 1) were supplemented by 29 patients (19 male, age 16-70) undergoing MRE-D and terminal ileal biopsy (cohort 2). Global (cohort 1) and terminal ileal (cohort 2) DWI signal was graded (0 to 3) by 2 radiologists and segmental apparent diffusion coefficient (ADC) calculated...
August 27, 2016: Abdominal Radiology
Makoto Naganuma, Shigeo Okuda, Tadakazu Hisamatsu, Katsuyoshi Matsuoka, Kiyoto Mori, Naoki Hosoe, Yoshihiro Nakazato, Haruhiko Ogata, Takanori Kanai
BACKGROUND: MR enterography (MRE) is useful for evaluating transmural lesions and extra-intestinal complications of Crohn's disease (CD). The aim of this study was to prospectively evaluate whether MRE could detect severe strictures and inflammatory lesions in patients who lost the responsiveness to anti-TNF treatment and whether MRE could predict prognosis of CD patients with clinical remission. PATIENTS AND METHODS: MRE were conducted in 50 patients who were treated with infliximab or adalimumab...
August 23, 2016: Abdominal Radiology
Jonathan R Dillman, Ethan A Smith, Ramon Sanchez, Jeremy Adler, Soudabeh Fazeli, Bin Zhang, Matthew S Davenport
OBJECTIVE: The purpose of this study was to determine prospectively whether bowel wall apparent diffusion coefficient (ADC) measurements can be used to monitor treatment response to infliximab therapy in the setting of pediatric small-bowel Crohn disease. SUBJECTS AND METHODS: Twenty-eight pediatric subjects with newly diagnosed biopsy-proven Crohn disease of the distal or terminal ileum treated with infliximab were enrolled. Subjects underwent MR enterography at baseline, 1 month after therapy, and 6 months after therapy...
November 2016: AJR. American Journal of Roentgenology
Eric C Ehman, Andrew S Phelps, Michael A Ohliger, Sue J Rhee, John D MacKenzie, Jesse L Courtier
PURPOSE: To evaluate the fused, colorized diffusion weighted imaging (DWI) and anatomic T2 images compared to routine contrast-enhanced T1 images at pediatric magnetic resonance enterography (MRE). METHODS: Fused, colorized DWI/T2 images were created from patients with magnetic resonance enterography (MRE) and colonoscopy/biopsy. Radiologists noted inflammation in five bowel segments (terminal ileum-rectosigmoid colon) on postcontrast images and DWI/T2 images. Test characteristics and agreement were calculated...
July 21, 2016: Clinical Imaging
Mengxia Li, Anke Dick, Nicole Hassold, Thomas Pabst, Thorsten Bley, Herbert Köstler, Henning Neubauer
BACKGROUND: The "Controlled Aliasing In Parallel Imaging Results In Higher Acceleration" (CAPIRINHA) technique greatly accelerates T1w 3D fast low angle shot (FLASH) scans while maintaining high image quality. We studied image quality and conspicuity of inflammatory lesions on CAIPIRINHA-accelerated imaging for pediatric small-bowel magnetic resonance imaging (MRI). METHODS: Forty-four consecutive patients (mean 14±3 years, 18 girls) underwent small-bowel MRI (MR enterography, MRE) at 1...
July 23, 2016: World Journal of Pediatrics: WJP
Frank I Scott, Gary R Lichtenstein
Mild Crohn's disease (CD) is classified as those patients who are ambulatory, with <10 % weight loss, are eating and drinking without abdominal mass, tenderness, obstructive symptoms, or fever, and endoscopically they have non-progressive mild findings. Initial evaluation of mild CD should focus on assessment for high-risk features requiring more aggressive therapy. In contrast to moderate-to-severe disease, where therapy is focused on mucosal healing, the management of mild CD is focused on symptom management, while exposing the individual to minimal therapeutic risks...
September 2016: Current Gastroenterology Reports
Matthew P Moy, Jess L Kaplan, Christopher J Moran, Harland S Winter, Michael S Gee
OBJECTIVE: The purpose of this study was to investigate the MR enterographic findings that best correlate with mucosal healing assessed with ileocolonoscopy. MATERIALS AND METHODS: Patients with Crohn disease who underwent two ileocolonoscopic examinations and also underwent MR enterography close in time to the second endoscopic examination were included in a retrospective study. Two pediatric gastroenterologists blinded to the imaging findings reviewed the endoscopic examinations to assess for mucosal healing, defined as resolution of inflammation within a bowel segment at subsequent ileocolonoscopy...
June 28, 2016: AJR. American Journal of Roentgenology
Olwen Westerland, Nyree Griffin
Over the past decade, magnetic resonance (MR) enterography has become established as the first-line imaging test for patients with Crohn׳s disease. This article reviews the role of MR enterography in assessing the extent and activity of Crohn׳s disease at baseline and on treatment follow-up. It discusses the role of diffusion-weighted imaging, and the recent introduction of MR scoring systems to facilitate noninvasive objective assessment of disease activity and cumulative bowel damage.
August 2016: Seminars in Ultrasound, CT, and MR
Satheesh Krishna, Naveen Kalra, Paramjeet Singh, Rakesh Kochhar, Rajesh Gupta, Rajinder Singh, Niranjan Khandelwal
OBJECTIVE: The purpose of this article is to describe the MR enterographic findings of small-bowel tuberculosis (TB) and to compare the imaging findings of small-bowel follow-through (SBFT) with those of MR enterography. SUBJECTS AND METHODS: Thirty patients (20 male and 10 female) presenting with suspected intestinal TB were enrolled in this prospective study. MR enterography and SBFT were performed within 2 weeks of each other. RESULTS: Nineteen of the 30 patients were confirmed to have TB...
September 2016: AJR. American Journal of Roentgenology
Charlotte J Tutein Nolthenius, Shandra Bipat, Banafsche Mearadji, Anje M Spijkerboer, Cyriel Y Ponsioen, Alexander D Montauban van Swijndregt, Jaap Stoker
PURPOSE: Multiple features have been described for assessing inflammation in Crohn's disease (CD) in MR enterography, but have not been validated in perianal magnetic resonance imaging (MRI). Retrospectively, we studied which MRI features are valuable in assessing proctitis. MATERIALS AND METHODS: CD patients (≥18 years) who underwent colonoscopy (reference standard) and perianal fistula MRI within 8 weeks were included. Seventeen MRI features were blindly scored by three observers and correlated to endoscopy (regression analysis)...
October 2016: Abdominal Radiology
Fabio Pomerri, Faise Al Bunni, Monica Zuliani, Graziella Guariso, Marco Gasparetto, Benedetta Giorgi, Mara Cananzi, Pier Carlo Muzzio
OBJECTIVES: This study was aimed at correlating a magnetic resonance index of activity (MaRIA) and a magnetic resonance enterography global score (MEGS) with activity indexes in a paediatric population with Crohn's disease (CD). METHODS: This retrospective study included 32 paediatric patients (median age 14.5 years, 18 male) with proven CD who underwent magnetic resonance enterography (MRE). A correlation analysis was performed on the MRE-based scores, the simplified endoscopic score for CD (SES-CD), the paediatric Crohn's disease activity index (PCDAI), and C-reactive protein (CRP) levels...
June 8, 2016: European Radiology
Mary-Louise C Greer
Magnetic resonance enterography (MRE) now plays a central role in diagnosing pediatric inflammatory bowel disease (IBD), and its role in other intestinal pathologies such as scleroderma is gradually expanding. MRE helps distinguish between Crohn disease and ulcerative colitis, defining extent and severity. Standard MRE protocols can be optimized in children and adolescents to be diagnostic and well tolerated, both of which are important with increasing use of serial MRE in pediatric IBD for monitoring treatment response and evaluating complications...
May 2016: Pediatric Radiology
Bjørn Rasmussen, Torben Nathan, Michael Dam Jensen
The main limitation of capsule endoscopy is the risk of capsule retention. In patients with suspected Crohn's disease, however, this complication is rare, and if a small bowel stenosis is not reliably excluded, small bowel patency can be confirmed with the Pillcam patency capsule. We present two patients examined for suspected Crohn's disease who experienced significant symptoms from a retained patency capsule. Both patients had Crohn's disease located in the terminal ileum. In one patient, the patency capsule caused abdominal pain and vomiting and was visualized at magnetic resonance enterography 9 days after ingestion...
May 17, 2016: Journal of Crohn's & Colitis
Nora Stanescu-Siegmund, Yessica Nimsch, Arthur P Wunderlich, Martin Wagner, Reinhard Meier, Markus S Juchems, Meinrad Beer, Stefan A Schmidt
BACKGROUND: Individual studies have demonstrated the potential of diffusion-weighted magnetic resonance imaging (DWI-MRI) for identifying inflamed bowel segments. However, these studies were conducted with rather small patient cohorts and in most cases by means of MR enterography only. PURPOSE: To demonstrate the feasibility of detecting inflamed bowel segments in a large collective of patients with Crohn's disease using DWI in MR enteroclysis and MR enterography and to compare the results of both techniques, also considering clinical parameters by means of the Harvey-Bradshaw Index (HBI)...
May 12, 2016: Acta Radiologica
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