Crohn's Disease Imaging: A Review

Crohn's disease is a chronic granulomatous inflammatory disease of the gastrointestinal tract, which can involve almost any segment from the mouth to the anus. Typically, Crohn's lesions attain segmental and asynchronous distribution with varying levels of seriousness, although the sites most frequently involved are the terminal ileum and the proximal colon. A single gold standard for the diagnosis of CD is not available and the diagnosis of CD is confirmed by clinical evaluation and a combination of endoscopic, histological, radiological, and/or biochemical investigations. In recent years, many studies have been performed to investigate the diagnostic potential of less invasive and more patient-friendly imaging modalities in the evaluation of Crohn's disease including conventional enteroclysis, ultrasonography, color-power Doppler, contrast-enhanced ultrasonography, multidetector CT enteroclysis, MRI enteroclysis, and 99mTc-HMPAO-labeled leukocyte scintigraphy. The potential diagnostic role of each imaging modality has to be considered in different clinical degrees of the disease, because there is no single imaging technique that allows a correct diagnosis and may be performed with similar results in every institution. The aim of this paper is to point out the advantages and limitations of the various imaging techniques in patients with suspected or proven Crohn's disease

Intussusception in Adults: The Role of MDCT in the Identification of the Site and Cause of Obstruction

Unlike pediatric intussusception, intestinal intussusception is infrequent in adults and it is often secondary to a pathological condition. The growing use of Multi-Detector Computed Tomography (MDCT) in abdominal imaging has increased the number of radiological diagnoses of intussusception, even in transient and nonobstructing cases. MDCT is well suited to delineate the presence of the disease and provides valuable information about several features, such as the site of intussusception, the intestinal segments involved, and the extent of the intussuscepted bowel. Moreover, MDCT can demonstrate the complications of intussusceptions, represented by bowel wall ischemia and perforation, which are mandatory to promptly refer for surgery. However, not all intussusceptions need an operative treatment. In this paper, we review the current role of MDCT in the diagnosis and management of intussusception in adults, focusing on features, as the presence of a leading point, that may guide an accurate selection of patients for surgery

Special Issue “Advancement in Breast Diagnostic and Interventional Radiology”

A multimodality approach in breast imaging is a unique solution to guarantee to the patient a complete diagnosis [...

Iodinated contrast media in diagnostic imaging: Cardiovascular side effects

Background: Cardiovascular side effects occur rarely after iodinated contrast media administration and no real data can be found in literature. The presence of cardiovascular risk factors increases the incidence of these adverse reactions. Objective: Aim of the study was the analysis of the cardiovascular side effects due to use of intra-venous iodinated contrast media in diagnostic imaging. Methods: A MEDLINE and Pubmed research was performed for journals with MeSH major terms â\u80\u9ciodinated contrast mediaâ\u80\u9d and â\u80\u9ccardiovascular side effectsâ\u80\u9d. Non-English speaking literature was excluded. Results: Intravenous iodine contrast agents could be determined with low frequency cardiovascular side effects, such as arrhythmias, related to increased levels of thyroid hormones. Indeed after the contrast media administration, in euthyroid patients the iodine stores remain elevated up to two months. Instead the vasomotor reactions (orthostatic hypotension and reflex tachycardia) and /or vasovagal response (syncope and bradycardia) are the most frequent. Conclusion: The rarity and the mild-moderate type of the cardiovascular side effects do not justify the electrocardiogram test as a preliminary exam for iodine contrast media usage. Emergency medical team should be alert in case of need. Atropine is the first choice in the hypotensive crisis due to contrast agents

Combined job's syndrome and klinefelter syndrome: A case report

To date, there are no case reports on combined Job's Syndrome (JS) and Klinefelter syndrome (KS). We describe the case of a 36-year-old man with KS and hyper-IgE Syndrome, detected at genetic tests. The patient, with testicular volume reduction, ginecomastia and hepatic steatosis underwent hormone replacement therapy with testosterone enanthate to increase testosterone blood levels, despite the side effects of the treatment and antibiotic prophylaxis against lung infections. This is the first case report of combined JS and KS diagnosed in young man, and it indicates the need to consider the concurrent existence of these two disorders in patients with recurrent lung infections, subcutaneous abscesses and IgE increase

The role of ultrasonography in gallbladder duplication

Gallbladder duplication is a rare congenital biliary malformation that occurs during the fourth and fifth embryonic week in about one in 4000 births. it may be diagnosed incidentally or during radiological investigation to symptoms associated with cholelithiasis and cholecystitis. Surgery of both structures is indicated only in symptomatic patients and in these cases pre-operative diagnosis is essential to prevent possible complication. Surgery is not recommended for asymptomatic double gallbladder. We describe a case of asymptomatic gallbladder duplication and we assess the role of ultrasonography