Enterography CT without and with water enema in patients with Crohn’s disease: Results from a comparative observational study in comparison with endoscopy

Minordi, Laura Maria; Scaldaferri, Franco; Marra, Roberta; Pecere, Silvia; Larosa, Luigi; Poscia, Andrea; Gasbarrini, Antonio; Vecchioli, A; Bonomo, Lorenzo

doi:10.1016/j.ejrad.2015.11.028

Cited by 10 publications

(4 citation statements)

References 24 publications

(35 reference statements)

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“…Finally, as for MR, studies assessing the accuracy of CT in the evaluation of CD, focussing on detection of lesions in the small bowel, have been performed to evaluate the value of CT for the characterization of inflammatory lesions in the colon [4].…”

Section: Introduction C R O H N's D I S E a S E ( C D )mentioning

confidence: 99%

Assessment of Crohn’s Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations

Minordi

Larosa

Papa

et al. 2019

JGLD

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Crohn’s disease (CD) is a chronic inflammatory transmural disease of the gastrointestinal tract. The small bowel is the most frequently involved site. Assessment of the bowel is essential in guiding therapeutic decisions, medical or surgical therapy. Personalized medicine is a new concept that has the potential to improve therapeutic efficacy, reduce the risk of drug adverse events, and decrease costs if the therapy is the most suitable treatment for selected patients. Many techniques have been verified and standardised for small bowel CD. Among radiological techniques, CT enterography (CTE) and MRI-enterography (MRE) are the most widely accepted techniques, although MRI is generally preferable as it avoids radiation. In this review, we will present the current role and new innovative technological perspectives of MR enterography in comparison with clinical and endoscopic evaluations for the assessment of CD activity in adult patients. In particular, many studies have been performed to validate MRE signs such as biomarkers of active Crohn’s disease (such as mural thickening, mural T2 hyperintense signal, target sign, comb sign, ulceration and extramural mesenteric signs) and to select the most appropriate index for identifying active disease or severe inflammation (such as MaRIA score, Clermont index, and others). We conclude that MRE is a minimally invasive tool for the evaluation of disease activity and shows a very good correlation with the presence and severity of endoscopic lesions, so to allow a personalized medicine in patients with CD.

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Section: Introduction C R O H N's D I S E a S E ( C D )mentioning

confidence: 99%

Assessment of Crohn’s Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations

Minordi

Larosa

Papa

et al. 2019

JGLD

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“…On-table monitoring of small bowel distension should be performed during both MR enteroclysis and CT enteroclysis, and infused volumes should be individualised for each patient. 170 Diagnostic accuracy for colonic inflammation is improved with colonic filling, either by prolonged oral contrast administration 188,189 or via a rectal liquid enema. 190 However, additional colonic preparation is not required for routine MR enterography or CT enterography.…”

Section: Patient Preparation and Basic Techniquementioning

confidence: 99%

ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 2: IBD scores and general principles and technical aspects

Sturm¹,

Maaser

Calabrese

et al. 2018

Journal of Crohn's and Colitis

307

217

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“…In the setting of chronic IBD, WE-MDCT has been validated by the Genoa group, consistently provides superior distension of the large bowel compared with CTE and optimally reproduces the well-known mural and extraluminal features of CD [ 10 – 12 ]. Furthermore, without the patient having to ingest polyethylenglycole solution, WE-MDCT achieves adequate luminal filling of the neoterminal ileum in a high proportion of patients with ileocecal resection (ICR) [ 9 – 12 ].…”

Section: Water Enema Multidetector Ct Technique and Interpretationmentioning

confidence: 99%

Imaging the operated colon using water-enema multidetector CT, with emphasis on surgical anastomoses

Tonolini

Ippolito

2018

Insights Imaging

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Water-enema multidetector CT (WE-MDCT) provides a detailed multiplanar visualisation of mural, intra- and extraluminal abnormalities of the large bowel, relying on preliminary bowel cleansing, retrograde luminal distension, pharmacological hypotonisation and intravenous contrast enhancement. In patients with a history of colorectal surgery for either carcinoma or Crohn’s disease (CD), WE-MDCT may also be performed via a colostomy, which allows depicting the anatomy and position of the residual large bowel and evaluates the calibre, length, mural and extraluminal features of luminal strictures. Therefore, WE-MDCT may prove useful as a complementary technique after incomplete or inconclusive colonoscopy to assess features and suspected abnormalities of the surgical anastomosis, particularly when endoscopic or surgical interventions are being planned. This pictorial essay presents the WE-MDCT technique and pitfalls, the expected appearances after different colic surgeries and the imaging features of benign anastomotic disorders (fibrotic stricture, kinking, inflammatory ulcer) and of locally recurrent tumours and CD.Teaching points• Water-enema multidetector CT (WE-MDCT) effectively visualises the operated colon• Complementary to endoscopy, WE-MDCT may helpfully depict abnormalities of surgical anastomoses• WE-MDCT allows assessment of strictures’ features and abnormalities of the upstream bowel• Technical pitfalls, normal postsurgical findings and benign anastomotic disorders are presented• WE-MDCT allows detecting relapsing Crohn’s disease, recurrent and metachronous tumours

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Enterography CT without and with water enema in patients with Crohn’s disease: Results from a comparative observational study in comparison with endoscopy

Cited by 10 publications

References 24 publications

Assessment of Crohn’s Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations

Assessment of Crohn’s Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations

ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 2: IBD scores and general principles and technical aspects

Imaging the operated colon using water-enema multidetector CT, with emphasis on surgical anastomoses

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