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MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations.

Dusunceli Atman E, Erden A, Ustuner E, Uzun C, Bektas M - Korean J Radiol (2015)

Bottom Line: This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma.MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey.

ABSTRACT
This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.

No MeSH data available.


Related in: MedlinePlus

Intraluminal duodenal diverticulum (IDD) in patient with anal atresia corrected by surgery.In barium study, contrast-filled inpouching towards lumen (arrow) is detected at 2nd portion of duodenum with radiolucent rim (halo sign) (A). In same patient, magnetic resonance cholangiopancreatography (MRCP) image shows fluid collection surrounded by hypointense rim (arrow) in duodenal lumen (B). Intraluminal fluid collection on T2-weighted image with hypointense rim that changes shape with peristaltism on MRCP is almost characteristic sign for IDD. By means of multiplanar imaging, it is possible to view diverticulum wall in duodenum lumen and content of liquid with conventional MR images and MRCP without need for oral contrast agent.
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Figure 7: Intraluminal duodenal diverticulum (IDD) in patient with anal atresia corrected by surgery.In barium study, contrast-filled inpouching towards lumen (arrow) is detected at 2nd portion of duodenum with radiolucent rim (halo sign) (A). In same patient, magnetic resonance cholangiopancreatography (MRCP) image shows fluid collection surrounded by hypointense rim (arrow) in duodenal lumen (B). Intraluminal fluid collection on T2-weighted image with hypointense rim that changes shape with peristaltism on MRCP is almost characteristic sign for IDD. By means of multiplanar imaging, it is possible to view diverticulum wall in duodenum lumen and content of liquid with conventional MR images and MRCP without need for oral contrast agent.

Mentions: Intraluminal duodenal diverticulum (IDD) is one of the most rarely seen congenital anomalies of the duodenum, and it is thought to arise from defects in the recanalization process of the primitive foregut in the early gestational period (12131415). Typically, it is seen at the 2nd section of duodenum, near the papilla Vateri (1213). IDD is gender-free and is most frequently seen in the 3rd-5th decades (12). Although it is mostly asymptomatic, sometimes it may cause early satiety, bloating, nausea, and/or vomiting based on partial or total duodenal obstruction (16). Forty percent of cases may be accompanied with GI and extraintestinal malformations, such as annular pancreas, midgut malrotation, imperforate anus, choledochocele, or superior mesenteric artery (SMA) syndrome as well as extraintestinal anomalies such as congenital heart disease, bladder extrophy, or hypoplastic kidney (121314). In barium studies, IDD is seen as a pedunculated polypoid lesion that is projected into the real lumen and that is filled with barium, creating the appearance of what is called a pathognomonic "airport windsock" (Fig. 7) (101213). Lesions change place with peristaltism. On T2-weighted images, a hypointense rim that covers the diverticulum lumen inside the duodenum lumen (Fig. 7) is also a very important sign in diagnosis. This liquid collection, which is hypointense in its surrounding and which changes shape and place with intestinal peristaltism, is nearly pathognomonic for the IDD diagnosis on MRI and MRCP (12).


MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations.

Dusunceli Atman E, Erden A, Ustuner E, Uzun C, Bektas M - Korean J Radiol (2015)

Intraluminal duodenal diverticulum (IDD) in patient with anal atresia corrected by surgery.In barium study, contrast-filled inpouching towards lumen (arrow) is detected at 2nd portion of duodenum with radiolucent rim (halo sign) (A). In same patient, magnetic resonance cholangiopancreatography (MRCP) image shows fluid collection surrounded by hypointense rim (arrow) in duodenal lumen (B). Intraluminal fluid collection on T2-weighted image with hypointense rim that changes shape with peristaltism on MRCP is almost characteristic sign for IDD. By means of multiplanar imaging, it is possible to view diverticulum wall in duodenum lumen and content of liquid with conventional MR images and MRCP without need for oral contrast agent.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644744&req=5

Figure 7: Intraluminal duodenal diverticulum (IDD) in patient with anal atresia corrected by surgery.In barium study, contrast-filled inpouching towards lumen (arrow) is detected at 2nd portion of duodenum with radiolucent rim (halo sign) (A). In same patient, magnetic resonance cholangiopancreatography (MRCP) image shows fluid collection surrounded by hypointense rim (arrow) in duodenal lumen (B). Intraluminal fluid collection on T2-weighted image with hypointense rim that changes shape with peristaltism on MRCP is almost characteristic sign for IDD. By means of multiplanar imaging, it is possible to view diverticulum wall in duodenum lumen and content of liquid with conventional MR images and MRCP without need for oral contrast agent.
Mentions: Intraluminal duodenal diverticulum (IDD) is one of the most rarely seen congenital anomalies of the duodenum, and it is thought to arise from defects in the recanalization process of the primitive foregut in the early gestational period (12131415). Typically, it is seen at the 2nd section of duodenum, near the papilla Vateri (1213). IDD is gender-free and is most frequently seen in the 3rd-5th decades (12). Although it is mostly asymptomatic, sometimes it may cause early satiety, bloating, nausea, and/or vomiting based on partial or total duodenal obstruction (16). Forty percent of cases may be accompanied with GI and extraintestinal malformations, such as annular pancreas, midgut malrotation, imperforate anus, choledochocele, or superior mesenteric artery (SMA) syndrome as well as extraintestinal anomalies such as congenital heart disease, bladder extrophy, or hypoplastic kidney (121314). In barium studies, IDD is seen as a pedunculated polypoid lesion that is projected into the real lumen and that is filled with barium, creating the appearance of what is called a pathognomonic "airport windsock" (Fig. 7) (101213). Lesions change place with peristaltism. On T2-weighted images, a hypointense rim that covers the diverticulum lumen inside the duodenum lumen (Fig. 7) is also a very important sign in diagnosis. This liquid collection, which is hypointense in its surrounding and which changes shape and place with intestinal peristaltism, is nearly pathognomonic for the IDD diagnosis on MRI and MRCP (12).

Bottom Line: This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma.MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey.

ABSTRACT
This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.

No MeSH data available.


Related in: MedlinePlus