MR Enterographic Manifestations of Small Bowel Crohn Disease

Tolan, Damian; Greenhalgh, Rebecca; Zealley, Ian; Halligan, Steve; Taylor, Stuart A.

doi:10.1148/rg.302095028

Cited by 220 publications

(178 citation statements)

References 50 publications

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“…Specifically, small bowel demonstrating the typical stigmata of CD (such as wall thickening, abnormal T 2 signal hyper enhancement etc.) 19 Figure 1. An example of a coronal reference frame displaying a SB ROI (left) with the corresponding motility map of the whole small bowel volume (right), based on the SD of the Jacobian determinant.…”

Section: Motility Assessmentmentioning

confidence: 99%

Relationship between MRI quantified small bowel motility and abdominal symptoms in Crohn’s disease patients—a validation study

Gollifer

Menys

Makanyanga

et al. 2018

BJR

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Section: Motility Assessmentmentioning

confidence: 99%

Relationship between MRI quantified small bowel motility and abdominal symptoms in Crohn’s disease patients—a validation study

Gollifer

Menys

Makanyanga

et al. 2018

BJR

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“…For all metrics, only small bowel with a normal appearance across all acquired MRI sequences was sampled i.e. any small bowel with typical MRI stigmata of Crohn's disease such as mural thickening (>3mm), abnormal mural T2 signal and increased contrast enhancement was excluded in any ROI placement 29 .…”

Section: Motility Assessmentmentioning

confidence: 99%

Aberrant Motility in Unaffected Small Bowel is Linked to Inflammatory Burden and Patient Symptoms in Crohnʼs Disease

Menys¹,

Makanyanga²,

Plumb³

et al. 2016

Inflammatory Bowel Diseases

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Objectives: Inflammation related enteric dysmotility has been postulated as a cause for abdominal symptoms in Crohn's disease (CD). We investigated the relationship between MRI-quantified small bowel (SB) motility, inflammatory activity and patient symptom burden.Methods: The Harvey Bradshaw Index (HBI) and fecal calprotectin were prospectively measured in 53 CD patients (median age 35, range 18-78) the day before MRI enterography which included a dynamic (cine), breath-hold motility sequence, repeated to encompass the whole SB volume. A validated registration based motility quantitation technique produced motility maps and regions of interest were drawn to include all morphologically normal SB (i.e. excluding diseased bowel). Global SB motility was correlated with calprotectin, HBI and symptom components (wellbeing, pain, diarrhea). Adjustment for age, sex, smoking and surgical history was made using multivariate linear regression.Results: Median calprotectin was 336 (range 0-1280). Mean HBI, motility mean and motility variance were 3 (range 0-16), 0.33 (0.18 to 0.51) and 0.01 (0.0014 to 0.034) respectively. Motility variance was significantly negatively correlated with calprotectin (Rho = -0.33, P = 0.015), total HBI (rho = -0.45, P <0.001), wellbeing (rho= -0.4, p=0.003), pain (rho = -0.27, p =0.05) and diarrhea (rho= -0.4, p=0.0025). The associations remained highly significant after adjusting for covariates. There was no association between mean motility and calprotectin or HBI (p>0.05).Conclusions: Reduced motility variance in morphologically normal small bowel is associated with patient symptoms and fecal calprotectin levels, supporting the hypothesis that inflammation related enteric dysmotility may explain refractory abdominal symptoms in CD.

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“…MR enterography is the best technique in the followup of IBD and can show intra-luminal and extra-luminal bowel diseases (9). If gastroenterologists who conducted follow-ups had paid more attention to his intestinal and extra-intestinal symptoms, they would have noticed IBD and exclude IPSID easily.…”

Section: Discussionmentioning

confidence: 99%

An Interesting Case of Misdiagnosed Inflammatory Bowel Disease With Immunoproliferative Small Intestine Disorder

et al. 2014

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Introduction: Inflammatory bowel disease (IBD) prevalence is increasing in Asia. Clinicians are faced with misdiagnosis for IBD even with classic symptoms. This case report shows that how a delayed diagnosis of IBD can produce significant problems for patient. Case Presentation: A 45 year-old man and known case of IPSID (Immunoproliferative small intestine disorder) was referred for follow-up to our GI (Gastrointestinal) clinic. He presented with a history of intractable watery diarrhea along with slight weight loss for the last 22 years. He was admitted with an episode of severe abdominal pain and acute peritonitis 10 years ago. At the time, laparotomy was performed due to a suspicious appendicular mass; however, the surgeon discovered a cecum mass and extended adhesion during laparotomy. According to IPSID diagnosis, he was then referred to an oncologist who treated him with chemotherapy and patient was advised to attend an annual colonoscopy checkup as follow-up. He was gradually complicated by renal stones, arthritis, hypoalbuminemia and bone disease during the follow-up. We as gastroenterologists reviewed his history again and requested a revision for all histopathology results by GI pathologist. Pathologist confirmed IBD (Crohn's disease) from the first pathology and his treatment was started immediately. Discussion: Several diseases can mimic IBD symptoms but with careful consideration of patient's symptoms, endoscopic findings and pathology results one should be able to diagnose IBD. Correct diagnosis of IBD can affect the quality of life of patient. Keywords:Inflammatory Bowel Diseases; Diagnostic Errors; Intestine, SmallImplication for health policy/practice/research/medical education: This case report shows that how a delayed diagnosis of IBD can produce significant problems for patient.

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MR Enterographic Manifestations of Small Bowel Crohn Disease

Cited by 220 publications

References 50 publications

Relationship between MRI quantified small bowel motility and abdominal symptoms in Crohn’s disease patients—a validation study

Relationship between MRI quantified small bowel motility and abdominal symptoms in Crohn’s disease patients—a validation study

Aberrant Motility in Unaffected Small Bowel is Linked to Inflammatory Burden and Patient Symptoms in Crohnʼs Disease

An Interesting Case of Misdiagnosed Inflammatory Bowel Disease With Immunoproliferative Small Intestine Disorder

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