Editorial for “Bowel Wall Visualization Using MR Enterography in Relationship to Bowel Lumen Contents and Patient Demographics”

2021 ◽  
Author(s):  
Mohammed Salman Shazeeb
Keyword(s):  
Bowel Wall ◽  
Mr Enterography ◽  
Bowel Lumen ◽  
Patient Demographics

Bowel Wall Visualization Using MR Enterography in Relationship to Bowel Lumen Contents and Patient Demographics

2021 ◽  
Author(s):  
Ting Ting Zhang ◽  
Wei‐Chou Chang ◽  
Zhen Jane Wang ◽  
Derek C. Sun ◽  
Michael A. Ohliger ◽  
...  
Keyword(s):  
Bowel Wall ◽  
Mr Enterography ◽  
Bowel Lumen ◽  
Patient Demographics

scholarly journals Dynamic Contrast-Enhanced MR with Quantitative Perfusion Analysis of Small Bowel in Vascular Assessment between Inflammatory and Fibrotic Lesions in Crohnʼs Disease: A Feasibility Study

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Davide Ippolito ◽  
Sophie Lombardi ◽  
Cammillo Talei Franzesi ◽  
Silvia Girolama Drago ◽  
Giulia Querques ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bowel Wall ◽  
Late Enhancement ◽  
Mr Enterography ◽  
Maximum Enhancement ◽  
Quantitative Perfusion ◽  
Vascular Assessment ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Significant Difference

Aim. To assess the feasibility of dynamic contrast-enhanced perfusion-MRI in characterization of active small-bowel inflammation and chronic mural fibrosis in patients with Crohnʼs disease (CD). Methods. We analyzed a total of 37 (11 women; 23–69 years) patients with known biopsy proven CD, who underwent MR-enterography (MRE) study, performed on a 1.5 T MRI system (Achieva, Philips), using a phased array sense body multicoil, after oral administration of 1.5–2 L of PEG solution. MRE protocol included T1 weighted, SSh T2, sBTFE, and gadolinium-enhanced THRIVE sequences acquired on coronal and axial planes. A dedicated workstation was used to generate perfusion color maps, on which we drown ROI on normal bowel and on pathological segment, thus obtaining related perfusion parameters: relative arterial, venous, and late enhancement (RAE, RVE, and RLE), maximum enhancement (ME), and time to peak (TTP). Results. Quantitative perfusion analysis showed a good correlation with local degree of Crohn’s inflammation activity. Twenty-nine out of 37 patients showed active inflammatory disease (reference standard of active disease: wall bowel thickness and layered enhancement) with following perfusion parameters: REA (%) = 116.1, RVE (%) = 125.3, RLE (%) = 127.1, ME (%) = 1054.7, TTP (sec) = 157. The same parameters calculated in patients with mural fibrosis were as follows: RAE (%): median = 56.4; RVE (%): 81.2; RLE (%): 85.4; ME (%):809.6; TTP (sec): 203.4. A significant difference (p<0.001) between inflamed and fibrotic bowel wall vascularity, regarding all perfusion parameters evaluated, was found, with higher values in active CD localizations. Conclusion. Vascular assessment of perfusion kinetics of bowel wall by dynamic contrast perfusion-MR analysis may represent a complementary diagnostic tool that enables a quantitative evaluation of local inflammation activity in CD patients.

scholarly journals Semi-automatic bowel wall thickness measurements on MR enterography in patients with Crohn's disease

2017 ◽  
Vol 90 (1074) ◽  
pp. 20160654 ◽  
Author(s):  
Robiel E. Naziroglu ◽  
Carl A.J. Puylaert ◽  
Jeroen A.W. Tielbeek ◽  
Jesica Makanyanga ◽  
Alex Menys ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Wall Thickness ◽  
Bowel Wall ◽  
Mr Enterography ◽  
Bowel Wall Thickness ◽  
Thickness Measurements

Normal small bowel wall characteristics on MR enterography

2010 ◽  
Vol 75 (2) ◽  
pp. 207-211 ◽  
Author(s):  
Carmel G. Cronin ◽  
Eithne Delappe ◽  
Derek G. Lohan ◽  
Clare Roche ◽  
Joseph M. Murphy
Keyword(s):  
Small Bowel ◽  
Bowel Wall ◽  
Mr Enterography

scholarly journals Quantification of inflammatory activity in patients with Crohn’s disease using diffusion weighted imaging (DWI) in MR enteroclysis and MR enterography

2016 ◽  
Vol 58 (3) ◽  
pp. 264-271 ◽  
Author(s):  
Nora Stanescu-Siegmund ◽  
Yessica Nimsch ◽  
Arthur P Wunderlich ◽  
Martin Wagner ◽  
Reinhard Meier ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Wall ◽  
Mr Enterography ◽  
Normal Bowel ◽  
Apparent Diffusion Coefficients ◽  
Diffusion Weighted ◽  
Mr Enteroclysis ◽  
Adc Values ◽  
Bowel Segments

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). Material and Methods Ninety-six patients underwent MRI enteroclysis and 35 patients MR enterography, both with additional DWI. The HBI as well as apparent diffusion coefficients (ADC) in areas of inflamed and normal bowel wall were determined. Thus resulting in 208 bowel segments that were visualized and subsequently statistically analyzed. Results There were no significant differences in ADC values in MR enteroclysis and MR enterography ( P = 0.383 in inflammation, P = 0.223 in normal wall). Areas of inflammation showed statistically highly significant lower ADC values than areas of normal bowel wall ( P < 0.001). An ADC threshold of 1.56 × 10–3 mm2/s can distinguish between normal and inflamed bowel segments with a sensitivity of 97.4% and a specificity of 99.2%. A highly significant correlation could be shown between ADC and HBI values ( P = 0.001). Conclusion DWI-MRI facilitates recognition of inflamed bowel segments in patients with Crohn’s disease and the ADC values show an excellent correlation to the HBI. There were no significant differences in ADC values in MR enteroclysis and MR enterography. An ADC threshold of 1.56 × 10–3 mm2/s differentiates between normal and inflamed bowel wall.

MR Enterography of Extraluminal Manifestations of Inflammatory Bowel Disease in Children and Adolescents: Moving Beyond the Bowel Wall

2012 ◽  
Vol 198 (1) ◽  
pp. W38-W45 ◽  
Author(s):  
Ethan A. Smith ◽  
Jonathan R. Dillman ◽  
Jeremy Adler ◽  
Vera L. Dematos-Maillard ◽  
Peter J. Strouse
Keyword(s):  
Inflammatory Bowel Disease ◽  
Children And Adolescents ◽  
Bowel Disease ◽  
Bowel Wall ◽  
Mr Enterography ◽  
Inflammatory Bowel

scholarly journals Crohn’s disease: prevalence, MR features, and clinical significance of enteric and colonic sinus tracts

2020 ◽  
Vol 30 (10) ◽  
pp. 5358-5366
Author(s):  
Martina Scharitzer ◽  
Bernd Koizar ◽  
Harald Vogelsang ◽  
Michael Bergmann ◽  
Christian Primas ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Wall Thickness ◽  
Bowel Wall ◽  
Sinus Tract ◽  
Mr Enterography ◽  
Bowel Distension ◽  
Bowel Wall Thickness ◽  
Bowel Segments ◽  
Mr Visible

Abstract Objectives Enteric and colonic sinus tracts are inflammatory complications that precede intestinal fistulas in patients with Crohn’s disease (CD). The aim of this study was to retrospectively determine the prevalence, morphologic features, and outcome of sinus tracts using MR imaging. Methods A consecutive cohort of 642 patients with known CD, referred for MR enterography or MR enteroclysis (study period 01/2014–09/2019), was evaluated retrospectively for the presence of sinus tracts, their locations, presence and length of coexisting strictures, bowel wall thickness, CDMI score, upstream dilation, and bowel distension. Clinical outcome was assessed using medical records. For metric data, means and standard deviation, as well as one-way ANOVA and Pearson’s correlation coefficient, were calculated. Results In 36/642 patients with CD undergoing MRE, 49 sinus tracts (forty in small intestine, nine in left-sided colon) were detected with a prevalence of 6.9% in patients with MR-visible signs of CD (n = 519, overall prevalence of 5.6%). Mean segmental bowel wall thickness was 8.9 mm, and mean CDMI score was 9.3. All sinus tracts were located within a stenotic segment, showing mesenteric orientation within the small bowel and upstream dilation in 13 patients. Of 36 patients, 19 underwent immediate surgery and seven developed clinical progression within the segment containing the sinus tract. Conclusions Sinus tracts occur in 6.9% of patients with visible signs of CD. They are located within stenotic, severely thickened bowel segments with high MR inflammation scores. Their detection is clinically important, because they indicate a more aggressive phenotype and, if left untreated, may show severe progression. Key Points • Sinus tracts occur in 6.9% of patients with MR-visible signs of Crohn’s disease. • Sinus tracts are a radiological indicator of early penetrating Crohn’s disease, with a high risk of progression, and require dedicated treatment. • Sinus tracts can be recognized by characteristic findings and typically occur in stenotic, severely thickened bowel segments with high MR inflammation scores.

Four-Corner Arthrodesis versus Proximal Row Carpectomy: Risk Factors and Complications Associated with Prolonged Postoperative Opioid Use

2020 ◽  
Author(s):  
Neill Y. Li ◽  
Alexander S. Kuczmarski ◽  
Andrew M. Hresko ◽  
Avi D. Goodman ◽  
Joseph A. Gil ◽  
...  
Keyword(s):  
Risk Factors ◽  
International Classification Of Diseases ◽  
Opioid Use ◽  
Proximal Row Carpectomy ◽  
Use Patterns ◽  
Patient Demographics ◽  
Implant Complications ◽  
Increased Risk ◽  
Classification Of Diseases

Abstract Introduction This article compares opioid use patterns following four-corner arthrodesis (FCA) and proximal row carpectomy (PRC) and identifies risk factors and complications associated with prolonged opioid consumption. Materials and Methods The PearlDiver Research Program was used to identify patients undergoing primary FCA (Current Procedural Terminology [CPT] codes 25820, 25825) or PRC (CPT 25215) from 2007 to 2017. Patient demographics, comorbidities, perioperative opioid use, and postoperative complications were assessed. Opioids were identified through generic drug codes while complications were defined by International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification codes. Multivariable logistic regressions were performed with p < 0.05 considered statistically significant. Results A total of 888 patients underwent FCA and 835 underwent PRC. Three months postoperatively, more FCA patients (18.0%) continued to use opioids than PRC patients (14.7%) (p = 0.033). Preoperative opioid use was the strongest risk factor for prolonged opioid use for both FCA (odds ratio [OR]: 4.91; p < 0.001) and PRC (OR: 6.33; p < 0.001). Prolonged opioid use was associated with an increased risk of implant complications (OR: 4.96; p < 0.001) and conversion to total wrist arthrodesis (OR: 3.55; p < 0.001) following FCA. Conclusion Prolonged postoperative opioid use is more frequent in patients undergoing FCA than PRC. Understanding the prevalence, risk factors, and complications associated with prolonged postoperative opioid use after these procedures may help physicians counsel patients and implement opioid minimization strategies preoperatively.

An Uncommon An Uncommon Cause of Acute Abdomen in Underprivileged Communities

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
David Muchuweti ◽  
Hopewell Mungani ◽  
Hopewell Mungani ◽  
Farai Mahomva ◽  
Edwin Gamba Muguti ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Acute Abdomen ◽  
Bowel Obstruction ◽  
Bowel Wall ◽  
Haemodynamic Instability ◽  
Small Bowel Volvulus ◽  
General Surgeons ◽  
Heavy Infestation ◽  
Emergency Abdominal Surgery

Oftentimes general surgeons working in poorly resourced communities carry out emergency abdominal surgery in patients with acute abdomen with no definitive preoperative diagnosis. The definitive diagnosis is made at laparotomy. Perforated small bowel obstruction secondary to heavy Infestation with Ascaris Lumbricoides brings a number of intraoperative challenges requiring correct intraoperative surgical management decisions. We present a case of a 17 year-old patient who was admitted with a diagnosis of small bowel obstruction who at laparotomy was found to have perforated gangrenous small bowel volvulus with heavy worm load visible through the bowel wall. Because of faecal peritoneal contamination and haemodynamic instability she underwent a two staged procedure with good outcome.

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