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1.
China Medical Equipment ; (12): 7-11, 2024.
Article in Chinese | WPRIM | ID: wpr-1026476

ABSTRACT

Objective:To investigate the quality control of magnetic resonance enterography(MRE)in the diagnosis of intestine diseases,and analyze the factors that affected the imaging quality of MRE,and enhance the imaging quality of MRE through adopted the measures of quality control.Methods:The documents of MRE examinations of 167 patients with intestinal disease who admitted to the 900th Hospital of People's Liberation Army Joint Service Support Force from May 2018 to March 2023 were retrospectively analyzed.The image qualities of all patients were evaluated after they completed clinical and image examinations.The reasons that image quality could not meet the requirement of diagnosis were analyzed.And then,the measures of quality control were proposed.Results:In 167 patients with intestinal disease,the MRE images of 153 patients(91.62%)could meet the requirement of diagnosis.In 14 patients(8.38%)whose MRE images could not meet the requirement of diagnosis,the reason of 3 cases(1.80%)was poor respiratory coordination,and that of 2 cases(1.20%)was there were more severe magnetic sensitive artifacts in images,and that of 1 case(0.60%)was severe intestinal peristalsis leaded to blurred images,and that of 2 cases(1.20%)was the flow void effect from intestinal peristalsis inside of intestinal cavity could not meet the requirement of diagnosis,and that of 4 cases(2.40%)was the intestinal tube without incomplete dilation caused by poor oral filling contrast agent,and that of 2 cases(1.20%)was many residues in intestine due to poor preparation for intestine.Aimed at the factors that MRE images could not meet requirement of diagnosis,we proposed the following quality control measures:①the biphasic contrast agents with favorable safety,without severe adverse reactions,which can fully dilate intestinal cavity,should be selected.②we should do well for the dilation of intestinal tube,and inhibit the intestinal peristalsis and conduct respiratory training.③we should conduct scan with wide field at coronal site,so as to display panorama image of intestine.④The scans of conventionally anatomical sequence and functional imaging sequence on axis position were performed on lesions.Conclusion:MRE technique should choose appropriate contrast agent in the quality control of the diagnosis of intestine diseases,and do well the preparation for patients before examination.Using intraluminal contrast agents,conducting intestinal dilation and optimal imaging technique are essential for obtaining intestinal MRE images with high quality.

2.
Article in Chinese | WPRIM | ID: wpr-1020809

ABSTRACT

Objective To develop a nomogram for predicting the risks of early anastomotic recurrence(EAR)after primary bowel resection in patients with Crohn's disease(CD).Methods The patients with CD under-going preoperative magnetic resonance enterography(MRE)and primary bowel resection were enrolled in this retrospective study and divided into an EAR group(18 patients)and EAR-free group(12 patients).The EAR group included the patients having an endoscopic Rutgeerts score of≥I2 month or the need for anastomotic resection within 12 months after surgery.All the 38 indexes including preoperative demographic characteristics,laboratory examina-tions,multi-parameter MRE features of the resected intestine and its adjacent mesentery,histological findings,and postoperative pharmacotherapy were analyzed.Least absolute shrinkage and selection operator(LASSO)regression and multivariate binary logistic regression analysis were performed to identify independent risk factors to be incorpo-rated into the nomogram for predicting the risks of early anastomotic recurrence and the prediction performance was evaluated.Results Mesenteric creeping fat index on MRE and comb sign were independent risks of EAR,with a concordance index of 0.882(95%CI:0.764~1).The calibration plot revealed a strong relationship between actual observation and predicted probability of EAR.Conclusions The preoperative MRE-based nomogram may be a potential tool for predicting EAR following surgery in patients with CD,which is beneficial to individual management in those patients.It provides reference for the formulation of early postoperative individualized drug adjuvant therapy in patients at high risk of EAR.

3.
Intestinal Research ; : 445-457, 2018.
Article in English | WPRIM | ID: wpr-715874

ABSTRACT

BACKGROUND/AIMS: Magnetic resonance enterography (MRE) has emerged as an important tool in the diagnosis and follow-up of Crohn's disease (CD). The aim of this study was to evaluate whether MRE findings could predict the prognosis of CD. METHODS: In this retrospective study, a total of 173 patients with clinical remission of CD (n=61) or active CD (n=112) were identified. The outcomes of clinical relapse, admission, surgery, and need for other medications according to the MRE findings were evaluated. RESULTS: The presence of active inflammation on MRE was observed in 93 (83%) patients with clinically active CD and in 44 (72.1%) patients with clinical remission of CD, without a statistically significant difference (P=0.091). In multivariate analysis, active inflammation on MRE increased the risk for clinical relapse (hazard ratio [HR], 6.985; 95% confidence interval [CI], 1.024–47.649) in patients with clinical remission of CD. In patients with clinically active CD, active inflammation on MRE increased the risk for CD-related hospitalization (HR, 2.970; 95% CI, 1.006–8.772). CONCLUSIONS: The presence of active inflammation on MRE was significantly associated with poor prognosis both in patients with clinical remission of CD and in those with active CD.


Subject(s)
Humans , Crohn Disease , Diagnosis , Follow-Up Studies , Hospitalization , Inflammation , Multivariate Analysis , Prognosis , Recurrence , Retrospective Studies
4.
J. pediatr. (Rio J.) ; J. pediatr. (Rio J.);93(4): 413-419, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-894035

ABSTRACT

Abstract Objective: To assess if magnetic resonance enterography is capable of showing evidence/extent of disease in pediatric patients with biopsy-proven celiac disease by comparing with a control group, and to correlate the magnetic resonance enterography findings with anti-endomysial antibody level, which is an indicator of gluten-free dietary compliance. Methods: Thirty-one pediatric patients (mean age 11.7 ± 3.1 years) with biopsy-proven celiac disease and 40 pediatric patients as a control group were recruited in the study. The magnetic resonance enterography images of both patients with celiac disease and those of the control group were evaluated by two pediatric radiologists in a blinded manner for the mucosal pattern, presence of wall thickening, luminal distention of the small bowel, and extra-intestinal findings. Patient charts were reviewed to note clinical features and laboratory findings. The histopathologic review of the duodenal biopsies was re-conducted. Results: The mean duration of the disease was 5.6 ± 1.8 years (range: 3-7.2 years). In 24 (77%) of the patients, anti-endomysial antibody levels were elevated (mean 119.2 ± 66.6 RU/mL). Magnetic resonance enterography revealed normal fold pattern in all the patients. Ten (32%) patients had enlarged mesenteric lymph nodes. Conclusion: Although a majority of the patients had elevated anti-endomysial antibody levels indicating poor dietary compliance, magnetic resonance enterography did not show any mucosal abnormality associated with the inability of magnetic resonance enterography to detect mild/early changes of celiac disease in children. Therefore, it may not be useful for the follow-up of pediatric celiac disease.


Resumo Objetivo: Avaliar se a enterografia por ressonância magnética (ERM) consegue comprovar/mostrar a extensão da doença em pacientes pediátricos com doença celíaca (DC) comprovada por biópsia, comparar com um grupo de controle e correlacionar os achados da ERM com o nível de anticorpo antiendomísio (EMA) indicador de dieta sem glúten. Métodos: Foram recrutados 31 pacientes pediátricos (idade média entre 11,7 ± 3,1 anos) com DC comprovada por biópsia e 40 pacientes pediátricos em um grupo de controle. As imagens da ERM dos pacientes com DC e no grupo de controle foram avaliadas por dois radiologistas pediátricos às cegas para o padrão da mucosa, presença de espessamento da parede, dilatação luminal do intestino delgado e achados extraintestinais. Os prontuários dos pacientes foram revisados para anotação de características clínicas e achados laboratoriais. A avaliação histopatológica das biópsias duodenais foi feita novamente. Resultados: A duração média da doença foi 5,6 ± 1,8 anos (faixa de 3-7,2 anos). Em 24 (77%) dos pacientes, os níveis EMA estavam elevados (média 119,2 ± 66,6 RU/mL). A ERM revelou um padrão de pregas normal em todos os pacientes; 10 (32%) dos pacientes apresentaram gânglios linfáticos mesentéricos aumentados. Conclusão: Apesar de a maioria dos pacientes ter níveis elevados de EMA, o que indica uma dieta pobre, a ERM não mostrou anomalia na mucosa associada à incapacidade de a ERM detectar alterações leves/precoces de DC nas crianças. Portanto, ela pode não ser útil no acompanhamento da DC pediátrica.


Subject(s)
Humans , Male , Female , Child , Adolescent , Magnetic Resonance Spectroscopy/methods , Celiac Disease/diagnostic imaging , Intestine, Small/diagnostic imaging , Case-Control Studies , Celiac Disease/pathology , Prospective Studies , Reproducibility of Results , Sensitivity and Specificity , Intestine, Small/pathology
5.
Article in English | WPRIM | ID: wpr-208828

ABSTRACT

OBJECTIVE: To prospectively evaluate the performance of diffusion-weighted imaging (DWI) to monitor bowel inflammation after medical therapy for Crohn's disease (CD). MATERIALS AND METHODS: Before and following 1–2 years of medical therapy, between October 2012 and May 2015, 18 randomly selected adult CD patients (male:female, 13:5; mean age ± SD, 25.8 ± 7.9 years at the time of enrollment) prospectively underwent MR enterography (MRE) including DWI (b = 900 s/mm²) and ileocolonoscopy. Thirty-seven prospectively defined index lesions (one contiguous endoscopy-confirmed inflamed area chosen from each inflamed anatomical bowel segment; 1–4 index lesions per patient; median, 2 lesions) were assessed on pre- and post-treatment MRE and endoscopy. Visual assessment of treatment responses on DWI in 4 categories including complete remission and reduced, unchanged or increased inflammation, and measurements of changes in apparent diffusion coefficient (ΔADC), i.e., pre-treatment–post-treatment, were performed by 2 independent readers. Endoscopic findings and CD MRI activity index (CDMI) obtained using conventional MRE served as reference standards. RESULTS: ΔADC significantly differed between improved (i.e., complete remission and reduced inflammation) and unimproved (i.e., unchanged or increased inflammation) lesions: mean ± SD (× 10⁻³ mm²/s) of -0.65 ± 0.58 vs. 0.06 ± 0.15 for reader 1 (p = 0.022) and -0.68 ± 0.56 vs. 0.10 ± 0.26 for reader 2 (p = 0.025). DWI accuracy for diagnosing complete remission or improved inflammation ranged from 76% (28/37) to 84% (31/37). A significant negative correlation was noted between ΔADC and ΔCDMI for both readers with correlation coefficients of -0.438 and -0.461, respectively (p < 0.05). CONCLUSION: DWI is potentially a feasible tool to monitor quantitatively and qualitatively bowel inflammation of CD after medical treatment.


Subject(s)
Adult , Humans , Crohn Disease , Diffusion , Endoscopy , Follow-Up Studies , Inflammation , Longitudinal Studies , Magnetic Resonance Imaging , Prospective Studies
6.
Article in Chinese | WPRIM | ID: wpr-608574

ABSTRACT

Objective To evaluate the diagnostic value of magnetic resonance enterography(MRE)and ectopic gastric mucosa imaging(EGMI)in children with lower gastrointestinal hemorrhage.Methods The clinical data including gender,age,amount of bleeding and preoperative minimum hemoglobin(Hb)levels of 54 children with lower gastrointestinal hemorrhage were collected,who received surgical exploration in Department of Pediatric Surgery,Anhui Provincial Children's Hospital between February 2014 and April 2016.Children were divided into lesion group and non-lesion group according to the findings of surgical exploration.Lesion group were defined as children with Meckel's diverticulum(MD)or duplication of the small intestine by surgery and postoperative pathological findings.A total of 36 cases,25 cases of boys,11 cases of girls,aged(2.86±1.59)years old.Non-lesion group were defined as children,who underwent operation with negative result or with lesions but not MD or duplication of the small intestine.A total of 18 cases,14 cases of boys,4 cases of girls,aged(3.87±1.62)years old.MRE and EGMI were performed when the children stopped bleeding,before the inspection,should fasting for 4-6 h.SPSS 13.0 software was used for statistical processing.The evaluation of EGMI,MRE and the both in diagnosing MD or duplication of the small intestine were conducted by receiver operating characteristic curve(ROC).According to the principles of biggest gain best diagnostic value by Youden index,and the degree of sensitivity and specificity was calculated at this time,P0.05).There were statistically significant differences in age,amount of bleeding and preoperative minimum hemoglobin levels(t=2.179,2.027,2.222,all P<0.05).There were statistically significant differences in classification comparison by EGMI and MRE between 2 groups(x2=15.226,29.121,all P<0.01).The optimal cut-off value of EGMI and MRE in the diagnosis of enteric malformation was more than level 3,and the suspected positive and being positive value was assigned as positive results.According to the cut-off value above,EGMI,MRE and EGMI plus MRE in series and in parallel in the diagnosis of enteric malformation,the areas under curves(AUC)were 0.809,0.917,0.750 and 0.847,respectively.The sensitivity was 61.1%,75.0%,55.6%and 80.6%,respectively.The specificity was 90.4%,94.4%,94.4%and 88.9%,respectively.The Youden's indexes were 0.515,0.694,0.500 and 0.695,respectively.The optimal cut-off value of age and preoperative minimum hemoglobin levels in the diagnosis of enteric malformation were 2.92 years and 80 g/L,respectively.The AUC was 0.761 and 0.672.The Youden's indexes were 0.515 and 0.333.There was no significant differences statistically in AUC compared with age,MRE and EGMI(all P<0.05).Conclusions The high diagnostic value in children with lower gastrointestinal hemorrhage is found by using MRE and EGMI.Then,MRE as a separate diagnosis method is also worthy of clinical application.

7.
Rev. argent. radiol ; 80(3): 183-191, set. 2016. ilus, tab
Article in Spanish | LILACS | ID: biblio-843229

ABSTRACT

La enfermedad inflamatoria intestinal es una patología crónica, con una incidencia cada vez mayor. Dentro de este grupo de afecciones, la enfermedad de Crohn y la colitis ulcerosa son las más frecuentes. La enterografía por tomografía computada (ETC) y por resonancia magnética (ERM) son las modalidades de elección para la evaluación y seguimiento de la entidad, permitiendo examinar la apariencia de la mucosa, la pared intestinal, las manifestaciones extraintestinales y las complicaciones asociadas. La elección del estudio debe hacerse de acuerdo con la condición clínica de cada paciente


Inflammatory bowel disease is a chronic condition with increasing incidence. Crohn's disease and ulcerative colitis are the most common pathologies. Computed tomography (CT) enterography and magnetic resonance (MR) enterography are the methods of choice for evaluating and monitoring this entity, assessing the appearance of intestinal wall, mucosa, extra-intestinal manifestations, and associated complications. The preferred imaging methods must be selected according to the clinical conditions of the patient


Subject(s)
Humans , Inflammatory Bowel Diseases/diagnostic imaging , Colitis, Ulcerative/diagnostic imaging , Crohn Disease/diagnostic imaging , Magnetic Resonance Spectroscopy , Tomography, X-Ray Computed
8.
Intestinal Research ; : 120-126, 2016.
Article in English | WPRIM | ID: wpr-111595

ABSTRACT

For the control of Crohn's disease (CD) a thorough assessment of the small intestine is essential; several modalities may be utilized, with cross-sectional imaging being important. Magnetic resonance (MR) enterography, i.e., MRE is recommended as a modality with the highest accuracy for CD lesions. MRE and MR enteroclysis are the two methods performed following distension of the small intestine. MRE has sensitivity and specificity comparable to computed tomography enterography (CTE); although images obtained using MRE are less clear compared with CTE, MRE does not expose the patient to radiation and is superior for soft-tissue contrast. Furthermore, it can assess not only static but also dynamic and functional imaging and reveals signs of CD, such as abscess, comb sign, fat edema, fistula, lymph node enhancement, less motility, mucosal lesions, stricture, and wall enhancement. Several indices of inflammatory changes and intestinal damage have been proposed for objective evaluation. Recently, diffusion-weighted imaging has been proposed, which does not need bowel preparation and contrast enhancement. Comprehension of the characteristics of MRE and other modalities is important for better management of CD.


Subject(s)
Animals , Humans , Abscess , Capsule Endoscopy , Comb and Wattles , Comprehension , Constriction, Pathologic , Crohn Disease , Diffusion Magnetic Resonance Imaging , Edema , Fistula , Intestine, Small , Lymph Nodes , Sensitivity and Specificity
9.
Article in English | WPRIM | ID: wpr-152286

ABSTRACT

Although ileocolonoscopy is the gold standard for diagnosis of inflammatory bowel disease and is useful for assessing the disease severity in the colon and terminal ileum, several alternative diagnostic techniques have been developed recently. For ulcerative colitis (UC), magnification colonoscopy, endocytoscopy, and confocal laser endomicroscopy enable assessment of histological inflammation without the need for biopsy. Capsule endoscopy is useful for detection of small intestinal and colonic lesions in both female and male patients. For UC, capsule endoscopy may be useful for evaluating colonic inflammation in patients with a previous poor colonoscopy experience, while it should be used only in Crohn's disease (CD) patients with unexplained symptoms when other examinations are negative. Magnetic resonance enterography (MRE) is particularly useful for detecting transmural inflammation, stenosis, and extraintestinal lesions, including abscesses and fistulas. MRE is also useful when evaluating small and large intestinal lesions, even in cases with severe strictures in which full evaluation of the small bowel would be virtually impossible using other devices. Therefore, the appropriate diagnostic devices for detecting CD lesions in the small and large intestine should be used.


Subject(s)
Humans , Colitis, Ulcerative/diagnosis , Crohn Disease/diagnosis , Cytodiagnosis/trends , Diagnostic Imaging/trends , Endoscopy, Gastrointestinal/trends , Magnetic Resonance Imaging/trends , Microscopy, Confocal/trends , Predictive Value of Tests , Prognosis , Severity of Illness Index
10.
Article in English | WPRIM | ID: wpr-150583

ABSTRACT

Crohn's disease is a chronic idiopathic inflammatory disease of the intestines characterized by frequent relapse and remission. It often develops in children and adolescents, who are vulnerable to repeated exposure to ionizing radiations. Magnetic resonance enterography (MRE) is an increasingly important radiation-free imaging modality that is used to evaluate pediatric patients with Crohn's disease. MRE can evaluate extraluminal and extraintestinal abnormalities as well as the status of the bowel wall. In addition, MRE has an advantage in the evaluation of the small bowel involvement. MRE can be used for the initial diagnosis of Crohn's disease, and can aid in the assessment of disease activity and complications such as penetrating and fibrostenotic diseases. The aims of this article are to review the MRE technique for obtaining diagnostic and high-quality images and to discuss interpretations of imaging findings in patients with Crohn's disease.


Subject(s)
Adolescent , Child , Humans , Crohn Disease , Diagnosis , Intestines , Magnetic Resonance Imaging , Radiation, Ionizing , Recurrence
11.
Clinical Endoscopy ; : 263-268, 2012.
Article in English | WPRIM | ID: wpr-216899

ABSTRACT

Crohn's disease (CD) is an inflammatory bowel disease that can affect the entire gastrointestinal tract, with the small bowel (SB) being the most commonly affected site. In some patients, refractory inflammation or chronic strictures of the SB are responsible for a debilitating course of the disease that might lead to severely reduced quality of life. Therefore, SB imaging is a crucial element in diagnosing and/or managing SB CD, and continues to evolve because of technologic advances. SB endoscopy (capsule endoscopy and device-assisted enteroscopy) and cross-sectional radiologic imaging (computed tomography enterography and magnetic resonance enterography) have become key players to diagnose and/or manage CD. In everyday practice, the choice of the imaging modalities is based on the presence and availability of the techniques and of experienced operators in each institute, clinical usefulness, safety, and cost. Here, SB endoscopy and radiologic imaging in suspected or known CD patients will be addressed and discussed.


Subject(s)
Humans , Constriction, Pathologic , Crohn Disease , Endoscopy , Gastrointestinal Tract , Inflammation , Inflammatory Bowel Diseases , Magnetic Resonance Spectroscopy , Quality of Life
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