Mural Inflammation in Crohn Disease: Location-Matched Histologic Validation of MR Imaging Features

Punwani, Shonit; Rodriguez‐Justo, Manuel; Bainbridge, Alan; Greenhalgh, Rebecca; Vita, Enrico De; Bloom, Stuart; Cohen, Richard; Windsor, Alastair; Obichere, Austin; Hansmann, Anika; Novelli, Marco; Halligan, Steve; Taylor, Stuart A.

doi:10.1148/radiol.2523082167

Cited by 227 publications

(192 citation statements)

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“…The most commonly used imaging features are well established in the literature for both CT scan [1][2][3][4] and MRI [5][6][7][8][9][10][11][12][13][14][15]. These include bowel wall thickening, bowel wall edema, perienteric edema and fluid, and mucosal, transmural, and possibly serosal hyperenhancement after intravenous contrast or gadolinium administration.…”

Section: Introductionmentioning

confidence: 99%

Erratum to: Identifying decreased peristalsis of abnormal small bowel segments in Crohn’s disease using cine MR enterography: the frozen bowel sign

et al. 2014

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Purpose: The purpose of this study was to evaluate whether affected bowel in Crohn's disease patients can be identified by observing decreased peristalsis (frozen bowel sign) using cine balanced steady-state free precession (cine BSSFP) images. Materials and methods: 5 radiologists independently reviewed cine BSSFP sequences from randomized MR Enterography (MRE) exams for 30 normal and 30 Crohn's disease patients, graded overall small bowel peristalsis from slowest to fastest, and graded peristalsis for the most abnormal small bowel segment. Sensitivity and specificity of the frozen bowel sign for diagnosing Crohn's disease were calculated. T tests of the peristalsis difference between abnormal segments and overall small bowel were conducted. Results: For 5 readers, the sensitivity and specificity of cine BSSFP of the frozen bowel sign for diagnosing Crohn's disease ranged from 70% to 100% and 87% to 100%, respectively. There were significant differences in peristalsis between abnormal small bowel segments and the overall small bowel for Crohn's patients, but not in the overall small bowel between normal-MRE patients and Crohn's disease patients. Conclusion: Abnormal Crohn's small bowel segments have significantly decreased peristalsis compared to normal small bowel, which can be identified using cine BSSFP sequences as the frozen bowel sign.Key words: MR enterography-Small bowelPeristalsis-Motility-Cine MRI-Crohn's disease Erratum to: Abdom Imaging DOI 10.1007/s00261-014-0258-yThe original publication did not include the images pertaining to the supplementary video files. This has been corrected in this article.Using MR enterography (MRE) to diagnose inflamed small bowel segments in patients with Crohn's disease requires a multiparametric approach, evaluating imaging features from several different pulse sequences. The most commonly used imaging features are well established in the literature for both CT scan [1][2][3][4] and MRI [5][6][7][8][9][10][11][12][13][14][15]. These include bowel wall thickening, bowel wall edema, perienteric edema and fluid, and mucosal, transmural, and possibly serosal hyperenhancement after intravenous contrast or gadolinium administration. With MRE, these Electronic supplementary material: The online version of this article

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Section: Introductionmentioning

confidence: 99%

Erratum to: Identifying decreased peristalsis of abnormal small bowel segments in Crohn’s disease using cine MR enterography: the frozen bowel sign

et al. 2014

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“…Masselli et al [42] confirmed that the terminal ileum is the most common localiazation of bowel wall thickness ( Figure 2). Stratified contrast enhancement with avid enhancement of the mucosa relative to the submucosa and muscular layers helps to confirm active CD [51] ( Figure 1C). High signal intensity in T2-weighted images indicates wall edema and it is an acute inflammation's sign [52] (Figure 3).…”

Section: Indicationsmentioning

confidence: 99%

Current tecniques and new perpectives research of magnetic resonance enterography in pediatric Crohn’s disease

Masselli

Mastroiacovo

Marco

et al. 2016

WJR

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Crohn's disease affects more than 500000 individuals in the United States, and about 25% of cases are diagnosed during the pediatric period. Imaging of the bowel has undergone dramatic changes in the past two decades. The endoscopy with biopsy is generally considered the diagnostic reference standard, this combination can evaluates only the mucosa, not inflammation or fibrosis in the mucosa. Actually, the only modalities that can visualize submucosal tissues throughout the small bowel are the computed tomography (CT) enterography (CTE) with the magnetic resonance enterography (MRE). CT generally is highly utilized, but there is growing concern over ionizing radiation and cancer risk; it is a very important aspect to keep in consideration in pediatric patients. In contrast to CTE, MRE does not subject patients to ionizing radiation and can be used to detect detailed morphologic information and functional data of bowel disease, to monitor the effects of medical therapy more accurately, to detect residual active disease even in patients showing apparent clinical resolution and to guide treatment more accurately.

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“…Die Kontrastmittelaufnahme ist geringer ausgeprägt als beim aktiven inflammatorischen Subtyp und meist auf die Mukosa beschränkt. Die geschichtete und homogene Kontrastmittelaufnahme sind seltener [9,23]. Bei Verwendung später kontrastmittelunterstützter Sequenzen kann eine protrahierte Kontrastmittelaufnahme beobachtet werden [24].…”

Section: Fibrostenosierender Subtypunclassified

Radiologische Charakterisierung chronisch-entzündlicher Darmerkrankungen

Schöllnast

2018

Radiologe

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Mural Inflammation in Crohn Disease: Location-Matched Histologic Validation of MR Imaging Features

Abstract: Increasing mural thickness, high mural signal intensity on T2-weighted fat-saturated images, and a layered pattern of enhancement reflect histologic features of acute small-bowel inflammation in Crohn disease.

Cited by 227 publications

References 31 publications

Erratum to: Identifying decreased peristalsis of abnormal small bowel segments in Crohn’s disease using cine MR enterography: the frozen bowel sign

Erratum to: Identifying decreased peristalsis of abnormal small bowel segments in Crohn’s disease using cine MR enterography: the frozen bowel sign

Current tecniques and new perpectives research of magnetic resonance enterography in pediatric Crohn’s disease

Radiologische Charakterisierung chronisch-entzündlicher Darmerkrankungen

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