17 research outputs found
Frequency and Nature of Incidental Extra-Enteric Lesions Found on Magnetic Resonance Enterography (MR-E) in Patients with Inflammatory Bowel Diseases (IBD)
The aim of this study was to determine the occurrence of extra-enteric findings in a large cohort of patients undergoing magnetic resonance enterography (MR-E) and to classify the clinical significance of these findings.We retrospectively analyzed 1154 MR-E performed in 1006 patients referred to our radiological department between 1999-2005. The reasons for referral were suspected or proven inflammatory bowel diseases (IBD) (n = 710), further diagnostic work-up for small bowel disease because of non-specific abdominal symptoms (SBD; n = 182) or suspected small bowel malignancies (SBM; n = 114). All extra-enteric findings were reviewed by a radiologist and a gastroenterologist and were classified as having high, moderate, or low significance for further diagnostic or therapeutic procedures.The average age of all patients was 40+/-16 (Mean+/-SD) years (y) (IBD 35+/-13 y; SBD 49+/-16 y; SBM 57+/-15 y). A total of 1113 extra-enteric findings were detected in 600 of 1006 patients (59.6%). Of these findings 180 (16.2%) were judged as having a high, 212 (19.0%) a moderate and 721 (64.8%) a low significance. On a per group basis in patients with IBD 12.0% of the findings were of major clinical significance compared to 13.7% and 33.3% in patients with SBD and SBM, respectively. The most common major findings were abscesses (69.9%) in the IBD group and extraintestinal tumors, metastases or masses in the SBD and SBM groups (41.9% and 74.2%, respectively).MR-E reveals a substantial number of extra-enteric findings, supporting the role of a cross-sectional imaging method for the evaluation of the small bowel
Abdominal lymphadenopathy in beta-thalassemia: MRI features and correlation with liver iron overload and posttransfusion chronic hepatitis C
OBJECTIVE. The objective of our study was to describe the MRI features
of abdominal lymphadenopathy in patients with beta-thalassemia major and
investigate the relation of abdominal lymphadenopathy with the severity
of iron overload and posttransfusion chronic hepatitis C.
MATERIALS AND METHODS. Abdominal MRI studies of 60 consecutive patients
with beta-thalassemia major, performed for quantification of liver iron
overload at a single institution, were retrospectively studied for the
presence of lymph nodes and their distribution, size, and number. The
signal intensity ratios of liver, spleen, and the largest lymph node to
the right paraspinous muscle (L/M, S/M, and LN/M, respectively) were
calculated on T1 -weighted gradient-echo images. MRI findings for the
lymph nodes were compared with the histologically assigned activity
level of chronic hepatitis C that was available in 17 patients who had
undergone liver biopsy within I month of the MRI examination.
RESULTS. Hypointense abdominal lymph nodes larger than 7 rum were seen
in 19 (32%) of 60 thalassemic patients in perihepatic and paraortic
distributions. Lymphadenopathy was related to both the severity of
hepatic siderosis, as expressed by the L/M values, and the presence of
chronic hepatitis C, given that 18 (95%) of the 19 thalassemic patients
with lymphadenopathy had chronic hepatitis C. Moreover, thalassemic
patients with a moderate or severe level of hepatic inflammation
presented with abdominal lymphadenopathy more frequently than those with
mild hepatic inflammation.
CONCLUSION. The development of hypointense abdominal lymphadenopathy in
patients with beta-thalassemia major who have received multiple
transfusions depends both on the severity of liver iron overload and on
the presence and the activity level of coexistent chronic hepatitis C
Shortened oral contrast preparation for improved small bowel distension at MR enterography
Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions
Real-time Sonography for Screening of Gallblader Dysfunction in Children with Type 1 Diabetes Mellitus
A computer-assisted model for detection of MRI signs of Crohnâs disease activity: Future or fiction?
Magnetic resonance imaging is increasingly used for abdominal evaluation and is more and more considered as the optimal imaging technique for detection of mural inflammation in patients with Crohnâs disease. Grading the disease activity is important in daily clinical practice to monitor the medical treatment and is assessed by evaluating different magnetic resonance imaging features. Unfortunately, only moderate interobserver agreement is reported for most of the subjective features and should be improved. A computer-assisted model for automatic detection of abnormalities, ability to grade disease severity, and thereby influence clinical disease management based on magnetic resonance imaging is missing. Recent techniques have focused on semi-automated methods for classification and segmentation of the bowel and also on objective measurement of bowel wall enhancement using absolute T1-values or dynamic contrast-enhanced imaging. This article reviews the available computerized techniques, as well as preferred developments.Image Science and TechnologyApplied Science