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Computed tomography enterography and magnetic resonance enterography in the diagnosis of Crohn's disease.

Kim SH - Intest Res (2015)

Bottom Line: Imaging of the small bowel is complicated by its length and its overlapping loops.Recently, however, the development of crosssectional imaging techniques, such as computed tomography enterography (CTE) and magnetic resonance enterography (MRE) has shifted fundamental paradigms in the diagnosis and management of patients with suspected or known Crohn's disease (CD).CTE and MRE are noninvasive imaging tests that involve the use of intraluminal oral and intravenous contrast agents to evaluate the small bowel.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.

ABSTRACT
Imaging of the small bowel is complicated by its length and its overlapping loops. Recently, however, the development of crosssectional imaging techniques, such as computed tomography enterography (CTE) and magnetic resonance enterography (MRE) has shifted fundamental paradigms in the diagnosis and management of patients with suspected or known Crohn's disease (CD). CTE and MRE are noninvasive imaging tests that involve the use of intraluminal oral and intravenous contrast agents to evaluate the small bowel. Here, we review recent advances in each cross-sectional imaging modality, their advantages and disadvantages, and their diagnostic performances in the evaluation of small bowel lesions in CD.

No MeSH data available.


Related in: MedlinePlus

A 15-year-old boy with CD. (A) Axial half-Fourier acquisition single-shot turbo spin-echo (HASTE) and (B) postcontrast T1-weighted magnetic resonance enterography images show marked distal ileal circumferential wall thickening with strong transmural hyperenhancement (arrowheads), consistent with active inflammation. (C) Axial diffusion-weighted image demonstrates the high signal intensity (arrowheads) associated with the involved ileum, suggesting the restricted diffusion of water within the distal ileum because of active inflammation.
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Figure 7: A 15-year-old boy with CD. (A) Axial half-Fourier acquisition single-shot turbo spin-echo (HASTE) and (B) postcontrast T1-weighted magnetic resonance enterography images show marked distal ileal circumferential wall thickening with strong transmural hyperenhancement (arrowheads), consistent with active inflammation. (C) Axial diffusion-weighted image demonstrates the high signal intensity (arrowheads) associated with the involved ileum, suggesting the restricted diffusion of water within the distal ileum because of active inflammation.

Mentions: MRI of the bowel relies predominantly on three sequences.27 The first is a single-shot fast spin-echo, or SSFSE, T2 sequence with a half-Fourier acquisition single-shot turbo spin-echo, or HASTE, that generates motion-free T2-weighted images to enable the evaluation of bowel wall edema and collections of extraluminal fluid (Fig. 6). The second sequence is a balanced steady-state free precession form of imaging, which includes true fast imaging with steady-state precession, or TrueFISP, and fast imaging employing steady-state acquisition, or FIESTA, and is exquisitely sensitive at detecting mesenteric changes, including hypervascularity, that is, comb sign, fibrofatty proliferation, and fistulas (Fig. 6). The third sequence is a dynamic fast 3D spoiled gradient echo T1 fat-suppressed post-contrast sequence that evaluates the pattern of bowel wall enhancement (Fig. 6), and includes volume interpolated breath-hold examination, or VIBE, and liver acquisition with volume acceleration, or LAVA. In addition to these 3 sequences, diffusion-weighted imaging (DWI) is gaining acceptance in abdominal MRI, because it assists in the identification of bowel segments affected by IBD (Fig. 7), and in the detection of lymph nodes, intra-abdominal and perianal abscesses, and penetrating complications.33,34,35


Computed tomography enterography and magnetic resonance enterography in the diagnosis of Crohn's disease.

Kim SH - Intest Res (2015)

A 15-year-old boy with CD. (A) Axial half-Fourier acquisition single-shot turbo spin-echo (HASTE) and (B) postcontrast T1-weighted magnetic resonance enterography images show marked distal ileal circumferential wall thickening with strong transmural hyperenhancement (arrowheads), consistent with active inflammation. (C) Axial diffusion-weighted image demonstrates the high signal intensity (arrowheads) associated with the involved ileum, suggesting the restricted diffusion of water within the distal ileum because of active inflammation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4316219&req=5

Figure 7: A 15-year-old boy with CD. (A) Axial half-Fourier acquisition single-shot turbo spin-echo (HASTE) and (B) postcontrast T1-weighted magnetic resonance enterography images show marked distal ileal circumferential wall thickening with strong transmural hyperenhancement (arrowheads), consistent with active inflammation. (C) Axial diffusion-weighted image demonstrates the high signal intensity (arrowheads) associated with the involved ileum, suggesting the restricted diffusion of water within the distal ileum because of active inflammation.
Mentions: MRI of the bowel relies predominantly on three sequences.27 The first is a single-shot fast spin-echo, or SSFSE, T2 sequence with a half-Fourier acquisition single-shot turbo spin-echo, or HASTE, that generates motion-free T2-weighted images to enable the evaluation of bowel wall edema and collections of extraluminal fluid (Fig. 6). The second sequence is a balanced steady-state free precession form of imaging, which includes true fast imaging with steady-state precession, or TrueFISP, and fast imaging employing steady-state acquisition, or FIESTA, and is exquisitely sensitive at detecting mesenteric changes, including hypervascularity, that is, comb sign, fibrofatty proliferation, and fistulas (Fig. 6). The third sequence is a dynamic fast 3D spoiled gradient echo T1 fat-suppressed post-contrast sequence that evaluates the pattern of bowel wall enhancement (Fig. 6), and includes volume interpolated breath-hold examination, or VIBE, and liver acquisition with volume acceleration, or LAVA. In addition to these 3 sequences, diffusion-weighted imaging (DWI) is gaining acceptance in abdominal MRI, because it assists in the identification of bowel segments affected by IBD (Fig. 7), and in the detection of lymph nodes, intra-abdominal and perianal abscesses, and penetrating complications.33,34,35

Bottom Line: Imaging of the small bowel is complicated by its length and its overlapping loops.Recently, however, the development of crosssectional imaging techniques, such as computed tomography enterography (CTE) and magnetic resonance enterography (MRE) has shifted fundamental paradigms in the diagnosis and management of patients with suspected or known Crohn's disease (CD).CTE and MRE are noninvasive imaging tests that involve the use of intraluminal oral and intravenous contrast agents to evaluate the small bowel.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.

ABSTRACT
Imaging of the small bowel is complicated by its length and its overlapping loops. Recently, however, the development of crosssectional imaging techniques, such as computed tomography enterography (CTE) and magnetic resonance enterography (MRE) has shifted fundamental paradigms in the diagnosis and management of patients with suspected or known Crohn's disease (CD). CTE and MRE are noninvasive imaging tests that involve the use of intraluminal oral and intravenous contrast agents to evaluate the small bowel. Here, we review recent advances in each cross-sectional imaging modality, their advantages and disadvantages, and their diagnostic performances in the evaluation of small bowel lesions in CD.

No MeSH data available.


Related in: MedlinePlus