Multimodality Imaging Review of Anorectal and Perirectal Diseases with Clinical, Histologic, Endoscopic, and Operative Correlation, Part II: Infectious, Inflammatory, Congenital, and Vascular Conditions

Ballard, David H.; Sangster, Guillermo; Tsai, Richard; Naeem, Syed; Nazar, Miguel; D'Agostino, H B

doi:10.1067/j.cpradiol.2018.07.013

Cited by 4 publications

(4 citation statements)

References 53 publications

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“…Computed tomography is helpful if imaging is needed expeditiously and large perianal abscess are suspected (Fig. 1) [19]. However, a dedicated perianal fistula protocol magnetic resonance (MR) examination is important in treatment planning in pCD.…”

Section: Initial Evaluation and Classification Of Perianal Crohn's Di...mentioning

confidence: 99%

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Multidisciplinary management of perianal Crohn's disease

Abushamma¹,

Ballard²,

Smith

et al. 2021

Current Opinion in Gastroenterology

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Purpose of reviewMultiple new medications with novel mechanisms of action are now available to treat Crohn's disease (CD). However, they have varying effectiveness in the management of perianal CD. Identifying the most appropriate therapy and optimizing it is essential to maximize effectiveness of therapy. Additionally, the management of perianal CD requires imaging of the perianal area to identify the fistula anatomy and local complications such as abscesses that require surgical drainage. Initial surgical assessment is key to drain abscesses and allow fistula healing with medical therapy. Recent findingsAlthough anti-tumor necrosis factor (TNFs) remain the most effective medications to treat perianal CD, realworld data suggests that ustekinumab may be a 2 nd -line option in patients nonresponsive to an anti-TNF or having contraindications. Mesenchymal stem cells are an emerging therapeutic approach that is currently in Phase 3 trials in the United States and poised to play a major role in the treatment algorithm.

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Section: Initial Evaluation and Classification Of Perianal Crohn's Di...mentioning

confidence: 99%

“…(b, c) The abscess was surgically drained and setons (arrows) placed in the fistulae. Reproduced with permission: Ballard et al [19].…”

Section: Key Pointsmentioning

confidence: 99%

Multidisciplinary management of perianal Crohn's disease

Abushamma¹,

Ballard²,

Smith

et al. 2021

Current Opinion in Gastroenterology

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“…12,13 On US, FG appears as a thickened, edematous scrotal wall and perineum with hyperechoic, hyperreflecting foci representing gas within the wall which demonstrate ring down artifact and ''dirty'' acoustic shadowing ( Figures 5 and 6). 14,15 The testes most often appear normal because of their independent blood supply which is not affected by the compromised facial and cutaneous circulation of the scrotum. 16 Doppler US demonstrates hyperemia and dilated scrotal vessels which are not seen on normal examinations.…”

Section: Ultrasoundmentioning

confidence: 99%

Fournier Gangrene in Men and Women: Appearance on CT, Ultrasound, and MRI and What the Surgeon Wants to Know

et al. 2020

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Fournier gangrene (FG) is a genitourinary necrotizing fasciitis that can be lethal if not promptly diagnosed and surgically debrided. The diagnosis is often made by physical examination paired with an appropriate clinical suspicion and supporting laboratory values. Imaging, particularly computed tomography (CT), plays a role in delineating involved fascial planes for operative debridement and occasionally in diagnosing FG. Less commonly, the imaging manifestations of FG may also be seen on ultrasound, radiographs, and magnetic resonance imaging. With the ubiquitous use and availability of CT, radiologists have a growing role in recognizing FG. This can be challenging in the absence of fascial gas, but a CT scoring system for necrotizing fasciitis can be helpful in making the diagnosis. Recent series suggest that this predominantly male disease has a rising incidence in women. Women with FG are more likely to be morbidly obese and have vulvar or labial involvement compared to men. Imaging mimics include ulcerative and necrotic tumors, traumatic or iatrogenic fascial gas, and vaginitis emphysematosa. The purpose of this pictorial review is to illustrate the imaging manifestations of FG and its mimics, with emphases on necrotizing fasciitis CT scoring systems and FG in women.

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“…Anorectal fistulae and abscesses are abnormal tracts and collections about the anus and rectum that occur with greater frequency in patients with Crohn disease [65]. Frequently, pelvic MRI may be obtained to delineate anatomy for treatment planning.…”

Section: Gastrointestinalmentioning

confidence: 99%

Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: abdominal, hepatobiliary, and gastrointestinal conditions

et al. 2020

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Background: Medical 3D printing has demonstrated value in anatomic models for abdominal, hepatobiliary, and gastrointestinal conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for abdominal, hepatobiliary, and gastrointestinal 3D printing indications. Methods: A literature search was conducted to identify all relevant articles using 3D printing technology associated with a number of abdominal pathologic processes. Each included study was graded according to published guidelines. Results: Evidence-based appropriateness guidelines are provided for the following areas: intra-hepatic masses, hilar cholangiocarcinoma, biliary stenosis, biliary stones, gallbladder pathology, pancreatic cancer, pancreatitis, splenic disease, gastric pathology, small bowel pathology, colorectal cancer, perianal fistula, visceral trauma, hernia, abdominal sarcoma, abdominal wall masses, and intra-abdominal fluid collections. Conclusion: This document provides initial appropriate use criteria for medical 3D printing in abdominal, hepatobiliary, and gastrointestinal conditions.

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Multimodality Imaging Review of Anorectal and Perirectal Diseases with Clinical, Histologic, Endoscopic, and Operative Correlation, Part II: Infectious, Inflammatory, Congenital, and Vascular Conditions

Cited by 4 publications

References 53 publications

Multidisciplinary management of perianal Crohn's disease

Multidisciplinary management of perianal Crohn's disease

Fournier Gangrene in Men and Women: Appearance on CT, Ultrasound, and MRI and What the Surgeon Wants to Know

Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: abdominal, hepatobiliary, and gastrointestinal conditions

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