MR enterography

Background: Radiologists show variable diagnostic performance and considerable inter-reader variability when interpreting MR enterography (MRE) examinations for suspected Crohn disease (CD). Objective: To develop a machine learning-based method for predicting ileal CD using radiomic features of ileal wall and mesenteric fat from noncontrast T2-weighted MR images, and to compare performance with that of expert radiologists. Methods: This single-institution study included retrospectively identified patients who underwent MRE for suspected ileal CD from January 1, 2020 to January 31, 2021, and prospectively enrolled participants (with newly diagnosed ileal CD or serving as healthy controls) from December 2018 to October 2021...

This review focuses on the role of magnetic resonance imaging (MRI) in the evaluation of the gastrointestinal tract (GI MRI), analyzing the major technical advances achieved in this field, such as diffusion-weighted imaging, molecular imaging, motility studies, and artificial intelligence. Today, MRI performed with the more advanced imaging techniques allows accurate assessment of many bowel diseases, particularly inflammatory bowel disease and rectal cancer; in most of these diseases, MRI is invaluable for diagnosis, staging, and disease monitoring under treatment...

OBJECTIVES: MR enterography (MRE) Index of Activity (MaRIA) and Clermont are validated scores that correlate with Crohn's disease (CD) activity; however, the Clermont score has not been validated to correlate with the degree of change in mucosal inflammation post induction treatment in children. This pilot study evaluated if MaRIA and Clermont scores can serve as surrogates to ileocolonoscopy for assessing interval change in mucosal inflammation in pediatric CD post-induction treatment...

BACKGROUND: Magnetic resonance enterography/enteroclysma (MRE) is an examination technique without ionizing radiation that allows assessment of bowel wall changes and extraluminal pathologies/complications such as in chronic inflammatory bowel diseases, among others. OBJECTIVES: To discuss requirements for optimal MR imaging of the small bowel, technical basis of MRE and principles for the development and optimization of a MRE protocol, and clinical indications for this specific imaging technique...

PURPOSE OF REVIEW: Capsule endoscopy is widely recognized as a safe and effective procedure to evaluate the small bowel and/or the colon noninvasively. Although infrequent, capsule retention is the most feared adverse event related to this technique. A better knowledge of risk factors, improvement of patients' selection and precapsule patency assessment may further contribute to reducing the incidence of capsule retention, even in patients at increased risk for this complication. RECENT FINDINGS: This review addresses the main risk factors for capsule retention, strategies for risk reduction such as patients' selection, dedicated cross-sectional imaging and rational use of the patency capsule, as well as management options and outcomes in the case of capsule retention...

Conditions that lead to small bowel mural thickening fall into a broad spectrum of diseases, including inflammatory, infectious, vascular or neoplastic. Computed tomography (CT) and Magnetic Resonance Imaging (MRI), especially CT-enterography and MR-enterography, permit evaluation of both entire small bowel and extraluminal structures. In CT/MR-enterography, the main prerequisite for the correct evaluation of small bowel is to obtain optimal intestinal distension. In fact, most errors are related to poor intestinal distension of the bowel which can lead to interpret as pathological a small bowel segment that is not very distended (false positive), or not to recognize presence of pathology in a collapsed segment (false negative)...

BACKGROUND:  MR-enterography/enteroclysis (MRE) is increasingly used for primary diagnosis, detection of complications, and monitoring of patients with inflammatory bowel disease (IBD). Standardization of reporting is relevant to ensure quality of the methodology and to improve communication between different faculties. The current manuscript describes the features that are required for optimized reporting of MRE in IBD. METHODS:  An expert consensus panel of radiologists and gastroenterologists conducted a systematic search of the literature...

AIM: We aimed to determine whether ulcerative colitis patients with preoperative negative computed tomography or magnetic resonance enterography (CTE/MRE) were less likely to develop Crohn's disease-like pouch complications (CDLPC) and establish risk factors and predictors for developing CDLPC. METHODS: This was a single centre retrospective analysis of patients with ulcerative colitis (UC) and inflammatory bowel disease unclassified (IBDU) who underwent total proctocolectomy with ileal J-pouch between January 2010 and December 2020...

Positron emission tomography (PET) magnetic resonance (MR) enterography is a novel hybrid imaging technique that is gaining popularity in the study of complex inflammatory disorders of the gastrointestinal system, such as inflammatory bowel disease (IBD). This imaging technique combines the metabolic information of PET imaging with the spatial resolution and soft tissue contrast of MR imaging. Several studies have suggested potential roles for PET/MR imaging in determining the activity status of IBD, evaluating treatment response, stratifying risk, and predicting long-term clinical outcomes...

PURPOSE: This study aimed to compare near-isotropic contrast-enhanced T1-weighted (CE-T1W) magnetic resonance enterography (MRE) images reconstructed with vendor-supplied deep-learning reconstruction (DLR) with those reconstructed conventionally in terms of image quality. METHODS: A total of 35 patients who underwent MRE for Crohn's disease between August 2021 and February 2022 were included in this retrospective study. The enteric phase CE-T1W MRE images of each patient were reconstructed with conventional reconstruction and no image filter (original), with conventional reconstruction and image filter (filtered), and with a prototype version of AIRTM Recon DL 3D (DLR), which were then reformatted into the axial plane to generate six image sets per patient...

PURPOSE OF REVIEW: Intrabdominal adhesions and intestinal hernias are the commonest cause of small bowel obstruction. Small bowel diseases, which cause small bowel obstruction, are rarer and often poses a challenge to gastroenterologists to diagnose and treat. In this review, small bowel diseases, which predispose to small bowel obstruction, are focused on, and their challenges in diagnosis and treatment. RECENT FINDINGS: Diagnosis of causes of partial small bowel obstruction is improved with computed tomography (CT) and magnetic resonance (MR) enterography...

Patients with Crohn's disease frequently suffer from fistula resulting from adverse sequelae of persistent complicated active disease or surgical intervention. Fistula affects a patient's quality of life and is directly associated with the need for surgical intervention. Diagnosis of fistula can be made through CT enterography, MR enterography, gastrograffin-based imaging, and transanal ultrasound. Treatment for fistula mainly consists of medication, endoscopic procedures, and surgery. There are emerging approaches under current investigation, such as stem cell therapy...

Many patients with Crohn's disease (CD) require surgical intervention during their lifetime. A correct preoperative assessment of the intestinal length is necessary to predict and quickly treat postoperative nutritional disorders. The aim of this paper is to explain the method used in our hospital to measure intestinal length in patients with CD and its usefulness for making the correct therapeutic decision. Vessel analysis software is used to measure small bowel length through computed tomography enterography (CTE) or magnetic resonance enterography (MRE)...

Background In Crohn disease, differentiation between active intestinal inflammation and fibrosis has implications for treatment, but current imaging modalities are not reliably accurate. Purpose To evaluate the predictive value of gallium 68 (68 Ga)-labeled fibroblast activation protein inhibitor (FAPI) PET/MR enterography for the assessment of bowel wall fibrosis in Crohn disease. Materials and Methods In this prospective single-center study, consecutive participants with Crohn disease and obstructive symptoms underwent preoperative 68 Ga-FAPI PET/MR enterography from May 2021 to January 2022...

OBJECTIVE: To compare computed tomography-enterography (CTE) and magnetic resonance-enterography (MRE) in the detection of right-sided bowel deep infiltrating endometriosis (DIE). MATERIALS AND METHODS: Fifty women with DIE who underwent preoperatively CTE and MRE were included. CTE and MRE were first analyzed separately by two independent readers who analyzed five bowel segments (cecum, appendix, ileocecal junction, distal ileum and proximal small bowel [i.e., proximal ileum and jejunum]) for the presence of DIE and then interpreted in consensus...

Neuroendocrine neoplasms (NEN) of the small bowel are typically slow growing lesions that remain asymptomatic until reaching an advanced stage. Imaging modalities for lesion detection, staging, and follow-up in patients with known or suspected NEN include CT enterography (CTE), MR enterography (MRE), as well as PET/CT using a somatostatin receptor analog. FDG PET/CT may have a role in the evaluation of poorly differentiated NENs. Liver MRI, ideally with a hepatocyte-specific contrast agent, should be used when in the evaluation of hepatic metastases...

OBJECTIVES: To investigate the prospective role of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in evaluating terminal ileal Crohn's disease (CD) inflammation quantitatively, compared with quantitative dynamic contrastenhanced magnetic resonance imaging (DCE-MRI) and ileocolonoscopic segmental score. METHODS: Fifty CD patients underwent magnetic resonance enterography (MRE) including IVIM-DWI and quantitative DCE-MRI from Jan. 2017 to Nov. 2019...

BACKGROUND: Crohn's disease (CD) is a potentially debilitating condition that burdens Italian healthcare substantially. The symptomatic management relies on prompt therapy adjustment to reduce flares and follow-up diagnostic inputs to maximise remission. Capsule endoscopy (CE) has introduced advantages in CD diagnostics, allowing the direct inspection of the entire gastrointestinal mucosa. The diagnostic procedure is comparable in effort to standard ileocolonoscopy (IC) but requires no anaesthesia...

BACKGROUND: Predicting clinical outcomes represents a major challenge in Crohn's disease (CD). Radiomics provides a method to extract quantitative features from medical images and may successfully predict clinical course. AIMS: The aim of this pilot study is to evaluate the use of radiomics to predict 10-year surgery for CD patients. METHODS: We selected a cohort of CD patients with CT scan enterographies and a 10-year follow up. The R library Moddicom was used to extract radiomic features from each lesion of CD, segmented in the CT scans...

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