Color Doppler Ultrasound Assessment of Clinical Activity in Inflammatory Bowel Disease.

BACKGROUND: Ulcerative colitis (UC) and Crohn's disease (CD) are two varieties of inflammatory bowel disease (IBD). Clinicians need a monitoring technique in the IBD. The disease activity can be assessed with endoscopy, activity indexes, and imaging techniques. Color Doppler US (CDUS) is also a non-invasive, radiation, and contrast material free examination which shows the intramural blood flow. OBJECTIVE: To evaluate the usefulness of B-mode, CDUS, and a newly developed software Color Quantification (CQ) to determine the activity of the IBD. METHODS: The disease activity was assessed by clinical activity indexes. Caecum, terminal ileum, ascending colon, transverse colon, and descending colon were evaluated by B-mode, CDUS, and the CQ. Bowel wall thickness (BWT), loss of bowel stratification, loss of haustration, and the presence of enlarged lymph nodes, mesenteric masses, abscesses, fistula, visual vascular signal patterns of the bowel as "hypo and hyper-flow" and the CQ values were investigated. BWT was compared with laboratory results and clinical activities. Vascular signal patterns and the CQ values were compared with BWT and clinical activity. The diagnostic performances of the CQ were investigated. RESULTS: Fifty-two patients with IBD were evaluated. Patients with increased BWT at the transverse colon had an increased frequency of "hyper-flow" pattern. Clinically active patients had an increased incidence of "hyper-flow" pattern at the terminal ileum, ascending colon, and whole segments. They had increased CQ values at the terminal ileum, ascending colon, and descending colon, and whole segments. A cut-off value for the CQ (24.7%) was obtained at the terminal ileum. In the diagnostic performances of CQ, we observed utilities significantly at the ascending colon, descending colon, terminal ileum, and whole segments. There was a positive correlation between the CQ values and BWT at the caecum, ascending colon, transverse colon, and descending colon. CONCLUSION: Increased visual vascular signal scores and CQ values might be useful for monitoring the disease activity in patients with IBD.

Magnetic resonance imaging findings of developmental venous anomalies.

PURPOSE: This study evaluated morphological features of developmental venous anomalies (DVAs) based on magnetic resonance imaging (MRI) findings. The study also evaluated the factors affecting the visibility of DVAs on MRI. METHODS: We reviewed contrast-enhanced MRIs of 75 patients with DVA. The images were selected from 1,165 consecutive cranial MRIs. The images were examined for the DVA location, the number of collecting veins, the collecting vein diameter, drainage veins and sinuses, any accompanying parenchymal abnormalities or lesions, and the DVA visibility on MRI. RESULTS: DVAs prevalence was determined as 6.4 %. A total of 88 DVAs were observed. Single DVAs were observed in 65 patients, two were observed in 7 patients and three were observed in 3 patients. The DVA caputs had deep localization most frequently in 54.5 % of patients. A total of 98 collecting veins were identified, with a single vein identified in 80 DVAs. A statistically significant difference (p = 0.000) was found in the diameter of the collecting veins between DVAs that were the visible and nonvisible on noncontrast MRI. CONCLUSIONS: Most frequently, a single DVA was observed in the patients. A DVA caput could be located in the deep, subcortical, juxtacortical or deep + subcortical and juxtacortical + subcortical regions. Increasing collecting vein diameter increased visibility on noncontrast MRI, and small DVAs could be overlooked, even with contrast-enhanced MRI series if the images were not examined carefully.

Diffusion-weighted imaging of the spine with a non-carr-purcell-meiboom-gill single-shot fast spin-echo sequence: initial experience.

BACKGROUND AND PURPOSE: To prospectively evaluate the signal-to-noise ratio (SNR) improvement in diffusion-weighted imaging (DWI) of the spine with the use of a newly developed non-Carr-Purcell-Meiboom-Gill (non-CPMG) single-shot fast spin-echo (SS-FSE) sequence and its effect on apparent diffusion coefficient (ADC) measurements. MATERIALS AND METHODS: Twenty-four patients were enrolled after written informed consent. DWI of the spine was obtained with an echo-planar imaging (EPI)-based sequence followed by a non-CPMG SS-FSE technique. SNR and ADC values were measured over a lesion-free vertebral corpus. A quality score was assigned for each set of images to assess the image quality. When a spinal lesion was present, contrast-to-noise ratio (CNR) and ADC were also measured. Student t tests were used for statistical analysis. RESULTS: Mean SNR values were 5.83 +/- 2.2 and 11.68 +/- 2.87 for EPI and non-CPMG SS-FSE DWI, respectively. SNR values measured in DWI using parallel imaging were found to be significantly higher (P < .01). Mean ADCs of the spine were 0.53 +/- 0.15 and 0.35 +/- 0.15 x 10(-3) mm(2)/s for EPI and non-CPMG SS-FSE DWI, respectively. Quality scores were found to be higher for the non-CPMG SS-FSE DWI technique (P < .05). Overall lesion CNR was found to be higher in DWI with non-CPMG SS-FSE. CONCLUSION: The non-CPMG SS-FSE technique provides a significant improvement to current EPI-based DWI of the spine. A study including a larger number of patients is required to determine the use of this DWI sequence as a supplementary tool to conventional MR imaging for increasing diagnostic confidence in spinal pathologic conditions.