CT enteroclysis and CT enterography — new approaches to assessing pathology of the small intestine

Enteroklyza i enterografia tomografii komputerowej są nowoczesnymi metodami diagnostycznymi pozwalającymi na dokładną ocenę patologii ściany jelita cienkiego z jednoczesną oceną zmian pozajelitowych i pełną oceną pozostałych narządów jamy brzusznej oraz miednicy mniejszej. Podstawowa różnica w metodyce badania między enterografią a enteroklyzą polega na odmiennym sposobie podania kontrastu, w przypadku enteroklyzy odbywa się to przez sondę założoną do pętli jelita cienkiego, a w czasie enterografii kontrast podawany jest doustnie. Rolą enteroklyzy/enterografii jest rozpoznanie chorób zapalnych jelita cienkiego, dalsze monitorowanie aktywności tych chorób oraz ocena ich powikłań, ocena jelita cienkiego w przypadku podejrzenia choroby nowotworowej tego fragmentu przewodu pokarmowego, a także identyfikacja źródła krwawienia z jelita cienkiego. Kluczową kwestią dla poprawnej interpretacji wykonanego badania jest należyte przygotowanie pacjenta — wypełnienie pętli jelitowych roztworem negatywnego środka kontrastowego oraz dobór odpowiedniej techniki badania w zależności od danych zawartych w skierowaniu. Niezmiennie ważną role odgrywa doświadczenie radiologa interpretującego badanie. Pełna ocena badania obejmuje ocenę toposcanu, obrazów poprzecznych, traktowanych zawsze jako obrazy referencyjne, oraz ocenę rekonstrukcji wielopłaszczyznowych i 3D. Szczególnie enterografia w opcji tomografii komputerowej jest bezpieczną i dobrze tolerowaną przez pacjentów metodą diagnostyczną pozwalającą na zdiagnozowanie oraz monitorowanie chorób zapalnych, nowotworów i malformacji naczyniowych jelita cienkiego.CT enteroclysis and CT enterography are modern diagnostic methods that allow a detailed assessment of the small intestine wall combined with an evaluation of extraintestinal lesions and a full examination of the remaining organs in the abdominal cavity and the pelvis. A major difference in examination methodology between enterography and enteroclysis is the different way in which a contrast medium is administered; in enteroclysis this is done through a catheter inserted into the small intestine, whereas in enterography the contrast medium is given orally. The purpose of enteroclysis/enterography is to identify inflammatory diseases of the small intestine, follow up on the progression of such diseases and assess their complications, evaluate the small intestine if this part of the gastrointestinal tract is supposed to be affected by a cancerous growth, as well as find the source of bleeding from the small intestine. A key issue for the correct interpretation that should follow the examination is to prepare the patient properly: fill intestinal loops with negative contrast medium solution and choose the right examination technique depending on the information contained in the referral. An invariably crucial role is played by the experience of the radiologist responsible for the interpretation of the examination. A full evaluation of the examination involves assessing a topographic scan, axial images, which are always treated as reference, and multiplanar and 3D reconstructions. In particular, CT enterography is a safe and well-tolerated diagnostic method that allows the diagnosing and monitoring of inflammatory diseases, neoplasia and vascular malformations of the small intestine

Age-related changes in the mRNA levels of CYP1A1, CYP2B1/2 and CYP3A1 isoforms in rat small intestine

It has been established beyond doubt that, as well as the liver, the small intestine is an important site of first-pass metabolism of numerous drugs, food components and toxic xenobiotics. However, there is not much information available about age-dependent changes of intestinal biotransformation pathways. In the present paper, we evaluated the relationships between intestinal cytochrome P450 complex activity and the age of animals. The study was carried out on male Sprague–Dawley rats (n = 5) from 5 age series: 0.5-, 2-, 4-, 20-, and 28 months old. Animals at every age series were divided into 4 groups: control and three groups of rats treated with the CYP450 specific inducers: phenobarbital, β-naphtoflavone and dexamethasone, respectively. RNA was isolated from intestinal mucosa, and then standard RT-PCR was used for the analysis of CYP1A1, CYP2B1/2 and CYP3A1 mRNA expression. Additionally, the activities of NADPH-cytochrome P450 and NADH-cytochrome b(5) reductases in the microsomal fraction were biochemically estimated. The constitutive intestinal CYP1A1 mRNA expression changes during maturation and aging. Inducibility of CYP1A1 gene was evident in intestinal mucosa at 2-, 4- and 20-month-old rats. A similar pattern of changes was observed for CYP2B1/2 isoforms. CYP3A1 mRNA expression was not detected in small intestine of 2-week-old rats. In matured rats, constitutive intestinal CYP3A1 expression was low, although after induction, significant increases in CYP3A1 mRNA amount were noted in aged individuals. Intestinal activity of both analyzed reductases was lowest in immature rats and highest in 28-month-old animals. In conclusion, the activity of cytochrome P450 complex in rat small intestine was not decreased by the aging processes, so the high rate of oxidative metabolic reactions in intestinal mucosa can be maintained till the advanced life stage