MR Enteroclysis in the Diagnosis of Small-Bowel Neoplasms

Weyenberg, Stijn J.B. Van; Meijerink, Martijn R.; Jacobs, Maarten; Peet, Donald L. van der; Kuijk, Cornelis van; Mulder, Chris J.; Waesberghe, J.H.T.M. van

doi:10.1148/radiol.09090828

Cited by 110 publications

(52 citation statements)

References 32 publications

(26 reference statements)

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“…MRI can be performed using two different approaches: MR enteroclysis or MR enterography [2][3][4][5][6][7][8][9].…”

Section: Technical Consideration and Methodologymentioning

confidence: 99%

“…Bowel wall thickness .3 mm must be considered abnormal [2][3][4][5][6][7][8][9][10][11][12]. MR is able to assess the morphology of the lesion and the endoluminal, mural and extramural abnormalities ( Figure 1); these findings are relevant for the differential diagnosis of small-bowel neoplasms.…”

Section: Image Interpretationmentioning

confidence: 99%

“…They usually grow intraluminally but can occasionally extend outward in the mesenteric surface, and the ileum is the more frequent location [1]. At MR they appear as sharply demarcated, sessile, small intraluminal lesions showing high signal intensity on T 1 weighted images and have signal intensity comparable to intra-abdominal fat on T 2 weighted images, with a typical loss of signal intensity on T 1 and T 2 weighted fat-suppressed images and without enhancement on post-gadolinium images [4] (Figure 5). …”

Section: Lipomamentioning

confidence: 99%

“…Major symptoms include abdominal pain, anaemia or obscure GI bleeding, leading clinicians to investigate many different conditions with a delay of several months from first clinical manifestation to diagnosis [1]. Conventional enteroclysis and capsule endoscopy are the most common procedures to visualise mucosal abnormalities, but are limited in the evaluation of mural and extramural extent of small-bowel tumours [2][3][4]. Therefore, radiologists assume a major role in the detection of small-bowel tumours.…”

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confidence: 99%

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MRI of the small-bowel: how to differentiate primary neoplasms and mimickers

Masselli¹,

Colaiacomo²,

Marcelli³

et al. 2012

BJR

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ABSTRACT. MRI of the gastrointestinal tract is gaining clinical acceptance and is increasingly used to evaluate patients with suspected small-bowel diseases. MRI may be performed with enterography or enteroclysis, both of which combine the advantages of cross-sectional imaging with those of conventional enteroclysis. In this paper, MRI features of primary small-bowel neoplasms, the most important signs for differential diagnosis and the diseases that can be considered as mimickers of small-bowel neoplasms, are discussed.

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“…MRI can be performed using two different approaches: MR enteroclysis or MR enterography [2][3][4][5][6][7][8][9].…”

Section: Technical Consideration and Methodologymentioning

confidence: 99%

Section: Image Interpretationmentioning

confidence: 99%

Section: Lipomamentioning

confidence: 99%

mentioning

confidence: 99%

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MRI of the small-bowel: how to differentiate primary neoplasms and mimickers

Masselli¹,

Colaiacomo²,

Marcelli³

et al. 2012

BJR

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“…The aim of diagnostic imaging of NENs in the small intestine is: -to present the primary focus; -to determine the local tumour size and presence of metastases; -to evaluate the response to treatment [32][33][34].…”

Section: Imaging Diagnosticsmentioning

confidence: 99%

Nowotwory neuroendokrynne jelita cienkiego i wyrostka robaczkowego — zasady postępowania (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

Bolanowski

Bednarczuk²,

Bobek-Billewicz³

et al. 2014

Endokrynologia Polska

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We present revised Polish guidelines regarding the management of patients harbouring neuroendocrine neoplasms (NENs) of the small intestine and appendix. The small intestine, especially the ileum, is the most common origin of these neoplasms. Most of them are well differentiated with slow growth. Rarely, they are less differentiated, growing fast with a poor prognosis. Since symptoms can be atypical, the diagnosis is often accidental. Typical symptoms of carcinoid syndrome occur in less than 10% of patients. The most useful laboratory marker is chromogranin A; 5-hydroxyindoleacetic acid is helpful in the monitoring of carcinoid syndrome. Ultrasound, computed tomography, magnetic resonance imaging, colonoscopy, video capsule endoscopy, balloon enteroscopy and somatostatin receptors scintigraphy are used in the visualisation. A histological report is crucial for the proper diagnostics and therapy of NENs, and it has been extensively described. The treatment of choice is surgery, either radical or palliative. Somatostatin analogues are crucial in the pharmacological treatment of the hormonally active and non-active small intestine NENs and NENs of the appendix. Radioisotope therapy is possible in patients with a good expression of somatostatin receptors. Chemotherapy is not effective in general. Everolimus therapy can be applied in patients with generalised NENs of the small intestine in progression and where there has been a failure or an inability to use other treatment options. Finally, we make recommendations regarding the monitoring of patients with NENs of the small intestine and appendix. (6) w mniej niż 10% przypadków. W diagnostyce laboratoryjnej najbardziej przydatne jest oznaczenie stężenia chromograniny A, badanie stężenia kwasu 5-hydroksyindolooctowego jest pomocne w monitorowaniu zespołu rakowiaka. W obrazowaniu stosuje się ultrasonografię, tomografię komputerową, rezonans magnetyczny, kolonoskopię, wideoendoskopię kapsułkową, enteroskopię dwubalonową, scyntygrafię receptorów somatostatynowych. Szczegółowe badanie histologiczne jest kluczowym dla właściwego rozpoznania i leczenia chorych z NEN jelita cienkiego i wyrostka robaczkowego. Leczeniem z wyboru jest postępowanie chirurgiczne, radykalne lub paliatywne. W leczeniu farmakologicznym czynnych i nieczynnych hormonalnie NEN jelita cienkiego i wyrostka robaczkowego podstawowe znaczenie mają analogi somatostatyny. Terapia radioizotopowa u chorych z dobrą ekspresją receptorów somatostatynowych stanowi kolejną opcję terapeutyczną. Chemioterapia jest na ogół nieskuteczna. U pacjentów z rozsianym NEN jelita cienkiego i progresją choroby oraz nieskutecznością innych metod terapii można zastosować ewerolimus. Przedstawiono także zalecenia odnośnie monitorowania chorych z NEN jelita cienkiego i wyrostka robaczkowego. (Endokrynol Pol 2013; 64 (6): 444-493)

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