Abstract:MR of the small bowel is a useful technique for the evaluation of both intraluminal and extraluminal pathologic involvement of the small bowel in patients with Crohn's disease. Crohn's disease is associated with a range of extraintestinal complications that sometimes may be the initial presenting symptoms. Some of these extraintestinal complications may not correlate with disease activity, but in general, they tend to follow the clinical course of disease and may have a high impact on life quality, morbidity, … Show more
“…During the last years, MRE has already been included in the evaluation protocol of CD patients, due to its accuracy in the appraisal of small bowel lesions and the lack of radiation exposure and invasiveness [16] , [17] .…”
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a multisystemic involvement. Usually, radiological imaging does not play a central role in evaluating SLE patients, although it may be helpful in assessing complications, allowing a more accurate evaluation of the patient. Lupus enteritis is one of the most common and potentially lethal manifestations of the gastrointestinal involvement of SLE. Among the imaging modalities, computed tomography scan is now considered the gold standard in evaluating lupus enteritis, although it is impaired by the radiation exposure. On the other hand, during the last decade magnetic resonance enterography has achieved a remarkable importance in evaluating small bowel lesions in patients affected by Crohn's disease. We describe the first case report of lupus enteritis evaluated with magnetic resonance enterography, putting forward the proposal of a reliable and radiation-free alternative to computed tomography scan in evaluating the intestinal involvement of SLE.
“…During the last years, MRE has already been included in the evaluation protocol of CD patients, due to its accuracy in the appraisal of small bowel lesions and the lack of radiation exposure and invasiveness [16] , [17] .…”
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a multisystemic involvement. Usually, radiological imaging does not play a central role in evaluating SLE patients, although it may be helpful in assessing complications, allowing a more accurate evaluation of the patient. Lupus enteritis is one of the most common and potentially lethal manifestations of the gastrointestinal involvement of SLE. Among the imaging modalities, computed tomography scan is now considered the gold standard in evaluating lupus enteritis, although it is impaired by the radiation exposure. On the other hand, during the last decade magnetic resonance enterography has achieved a remarkable importance in evaluating small bowel lesions in patients affected by Crohn's disease. We describe the first case report of lupus enteritis evaluated with magnetic resonance enterography, putting forward the proposal of a reliable and radiation-free alternative to computed tomography scan in evaluating the intestinal involvement of SLE.
“…On CT or magnetic resonance imaging (MRI), mass forming cholangiocarcinoma typically appears as an infiltrative hepatic mass with capsular retraction, delayed enhancement on postcontrast imaging, and sometimes intrahepatic biliary ductal dilatation (Fig. 1) (8). The mass is typically T2 hyperintense on MRI and poorly enhancing after gadolinium; diffusion weighted imaging improves detection of tumor (16).…”
Section: Hepatobiliary Diseasementioning
confidence: 99%
“…Magnetic resonance (MR) and computed tomography (CT) enterography of abdominopelvic EIMs in CD has been reviewed in several recent reports (7)(8)(9)(10). Our review covers multisystem EIMs seen in patients with IBD, including sites other than the abdomen and pelvis.…”
Inflammatory bowel disease (IBD) is associated with a spectrum of extraintestinal manifestations (EIMs) affecting many organ systems. EIMs can occur in more than 40% of patients with IBD and are associated with significant morbidity. They occur at any time point in the course of disease, often during an active phase of bowel inflammation, but sometimes preceding bowel disease. Prompt recognition of EIMs enables timely and more effective therapy. Physicians who image patients with IBD should be aware of the myriad extraintestinal conditions that may be detected on imaging studies, both within and outside of the abdomen, as they may predate the diagnosis of IBD. Cross-sectional imaging of unusual conditions associated with IBD will be presented, including pathology in the hepatobiliary, pancreatic, genitourinary, musculoskeletal, mucocutaneous, vascular, neurologic, and pulmonary systems.
“… Extraenteric manifestations of CD can also be evaluated with CT or MR imaging (Fig. 3 ): sclerosing cholangitis, cholelithiasis, liver abscess, portal vein thrombosis, pancreatitis, hydronephrosis caused by ureteral involvement, nephrolithiasis, IBD-related arthropathy (progressive ankylosing spondylitis and sacroiliitis), osteoporosis, peritoneal pseudocysts and cutaneous manifestations [ 30 ]. Fig.…”
Section: Computed Tomography (Ct)mentioning
confidence: 99%
“…Extraintestinal manifestations of IBD are easily detectable with MRI; sclerosing cholangitis, one of the most serious ones, with a relatively high prevalence in IBD patients (~4.5 %), has been shown to be easily and accurately investigated with MR cholangiopancreatography (MRCP). MRCP is a non-interventional method that also has the benefit of no need for sedation or exposure to radiation and comparable results to the gold standard technique, ERCP [ 30 , 38 ].…”
Section: Magnetic Resonance Imaging (Mri)mentioning
Background: The diagnosis of inflammatory bowel disease (IBD) in children and adolescents is based on the integration of clinical, biological, endoscopic, histological and radiological data. Methods: The most important part of the diagnosis is the histology, which is acquired by endoscopy. Imaging of the small bowel has changed in recent years, but the imaging goals are primarily to determine the extent of small bowel involvement, assess complications and define candidates for surgery. Imaging techniques are divided into conventional and cross-sectional ones. Results: The spectrum of imaging findings of cross-sectional techniques is discussed, emphasising the advantages and limitations of each technique, acknowledging the specificities of the paediatric population. Cross-sectional techniques have advanced the ability to diagnose and monitor inflammatory disease of the small bowel. Conclusion: MR enterography is the technique of choice in children with known IBD, for the investigation of the small bowel and the whole GI tract. US should be the first choice examination in children with suspected IBD, while CT should be reserved for cases in which MRI is contraindicated or in acute emergency situations when US is inadequate.Teaching Points• Cross-sectional imaging of the small bowel is essential in paediatric IBD.• Endoscopy is unable to assess extramural disease and examine the entire small bowel.• US should be the first choice examination in children with suspected IBD.• MR enterography is the technique of choice in children with known IBD.• There are still controversies regarding the prediction of disease activity or fibrosis.
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