Conventional enteroclysis with complementary MR enteroclysis: a combination of small bowel imaging

Current MR-Enterography In The Diagnosis Of Crohn’s Disease, An Update.

“…In endoscopy; Aftos ulcerations and erosions are found out initially in the normal bowel mucosa than at later stages, mural stratification with longitudinal and transverse ulcerations are observed (7,14,20,21). On MRI; High bowel wall enhancement is particular at active inflammation, increased signal at bowel wall and adjacent mesentery on T2W images, strictures-fistulization and abcesses are the main complications and hyperintense on T2W images, asymmetrically thickened mucosal folds and lymphadenopathy, mesenteric stranding of the effected bowel wall and prominent draining vessels of the inflamed intestinal loops(comb sign), presence of intramural fat at chronic phase and target sign due to wall thickening at acute phase, surrounding periintestinal edema in acute phase are the main findings of Crohn's disease (7,12,14,(18)(19)(20)(21) (Figure 2a-b) Mucosal irregularities and ulcerations, strictures and fistulas at chronic stage can also be visualized by enteroclysis (3,4,14,15,22) (Figure 3a-b-c).Clinical signs of Crohn's disease are; Abdominal ache, diarrhea, fever, loss of weight, malnutrition, hemorrhage and fistulas, its extra-intestinal manifestations are: Arthritis, iridocyclitis, erthytema nodosum, aftoz stomatitis, cholelithiasis, primary sclerosing cholangitis and ankylosing spondylitis (8)(9)(10)(11)(12)(13)(14)(15)(16)(20)(21)(22).In the differential diagnosis; Ulcerative colitis(UC), ischemic colitis(IC), infectious-fungal and tuberculous(Tbc) enteritis, radiation enteritis, major pathognomonic findings of it, lung involvementcalcified mesenteric lymphadenopathy and peritonitis are the common manifestations of Tbc (24)(25)(26). In the infectious en...…”

“…Lymphomas are also most commonly seen in ileum, luminal dilatation with mucosal necrosis and asymmetric bowel wall thickening are the major characteristics of lymphoma's, moderate contrast enhancement of intestinal wall, preserved mesenteric tissues with lymphadenopathies , long segment involvement, increased wall signal on T2W images are the other common findings, obstruction of intestinal lumen due to lymphoma is quite rare (14,22,23,26). Behcet's disease often presents aftos lineer ulcerations in the terminal ileum and ileoceccal valve, also regard genital-oral and orbital ulcerations but histopathological differentiation from Crohn's disease, can be necessary in most of the cases due to their similar involvement patterns (14,26,28).…”

Small Bowel Imaging - Still a Radiologic Approach?

“…On the other hand, competing cross-sectional methods are not able to assess superficial mucosal lesions in inflammatory diseases in such details 4,5 . CE is the most efficient diagnostic modality in evaluating cases of postoperative obstruction -etiology, location and determination the degree of obstruction 6 .…”

Feasibility of an optimized MR enterography protocol in the evaluation of pediatric inflammatory bowel disease

“…MRI of the bowel also known as MR enterography (MRE) has the potential to impact three important aspects of patient care: diagnosis, management, and treatment monitoring (10,12,13). These studies have used a variety of imaging protocols.…”

“…These studies have used a variety of imaging protocols. To facilitate the diagnostic value of MRE, a standard, optimized protocol should be used (12,13).…”