ABSTRACT
AIM: Magnetic resonance (MR) enterography is a radiation-free small bowel investigation which identifies luminal and extra-luminal pathology in patients with Crohn's disease. Most studies have validated MR against conventional radiology. We evaluated the results of MR enterography by comparison with findings at elective surgery for patients with Crohn's disease, including complex pathology. METHOD: Between January 2007 and March 2012 the results of preoperative MR enterography for Crohn's disease in consecutive patients in one unit were compared with the detailed findings at surgery. RESULTS: Fifty-one patients underwent 55 laparotomies during the study period. MR enterography identified the presence of Crohn's disease in the distal ileum in 33/34 patients, in the proximal ileum in 7/12 patients, in the jejunum in 7/8 patients, in the large bowel in 10/11 patients and in the duodenum in one of two patients. MR enterography identified ileo-enteric fistula in 10/12 patients, ileosigmoid fistula in all of seven patients and other fistulae in 10/11 patients. An abscess was identified on MR enterography in eight of nine patients. Within abnormal distal ileal segments, the mean contrast enhancement ratio of acute inflammation was 2.39 ± 0.59 compared with 1.82 ± 0.63 (P < 0.05) in segments with fibrosis only. CONCLUSION: Magnetic resonance enterography identifies small bowel Crohn's disease with an accuracy similar to or better than those of previously published series. Fistulation, abscess formation and large bowel disease can be reliably identified and disease activity assessed. Normal, uninvolved small bowel length can also be measured. Discrete proximal small bowel lesions may not always be detected. In our practice, MR enterography has replaced conventional radiology in the assessment of symptomatic patients with Crohn's disease.
Subject(s)
Crohn Disease/diagnosis , Enteritis/diagnosis , Ileal Diseases/diagnosis , Intestinal Fistula/diagnosis , Magnetic Resonance Imaging , Sigmoid Diseases/diagnosis , Abdominal Abscess/diagnosis , Abdominal Abscess/etiology , Adolescent , Adult , Aged , Colitis/diagnosis , Colitis/etiology , Crohn Disease/complications , Crohn Disease/surgery , Enteritis/etiology , Female , Humans , Ileal Diseases/etiology , Intestinal Fistula/etiology , Intestine, Small , Male , Middle Aged , Sigmoid Diseases/etiology , Young AdultABSTRACT
Fluorescent lanthanide complexes were synthesized using a non-phenolic analog of curcumin as the principal chromophoric chelating ligand. Sensitized, near-infrared fluorescence is observed in these complexes as a result of photo-excitation of the chromophoric ligands, population of the molecular triplet state, and transfer of energy to the emitting lanthanide ion. For the purpose of intra-molecular energy transfer, the triplet states of curcuminoid ligands are more favorably matched with the excited electronic states of neodymium and ytterbium ions than those associated with less conjugated beta-diketonate ligands. Sensitization of fluorescence through an internal redox reaction, thought to occur in other ytterbium complexes, is predicted to be less probable under the present circumstances.
ABSTRACT
RATIONALE AND OBJECTIVES: Polymer-stabilized manganese(II)-substituted hydroxylapatite (MnHA) has been investigated as a particulate contrast agent for magnetic resonance imaging. The MnHA core requires a polymer coating to retard opsonization, thereby prolonging its systemic persistence. Therefore, the aim of this study was to assess the stability of various formulations in biologic media in vitro. METHODS: Polyethyleneglycol-coated manganese(II)-substituted hydroxylapatite particles were studied in bovine plasma as a function of the concentration of polymer in the formulation. Particle sizing techniques and nuclear magnetic resonance proton relaxometry were used to evaluate both in vitro and in vivo stability. RESULTS: A small-sized particle (approximately 10 nm diameter) that is stable in bovine plasma and rabbit whole blood was formed in formulations with high amounts of polymer concentration. In formulations with low amounts of polymer concentration, larger-sized particles (approximately 100 nm diameter) were present along with the small-sized population. The larger particles de-aggregated into the small-size particle distribution on dispersion in bovine plasma and rabbit whole blood. CONCLUSIONS: Ultrasmall particles with high surface coat were stable in plasma, whereas larger aggregates de-aggregated. Unlike Mn2+, the interaction of polyethyleneglycol-stabilized manganese(II)-substituted hydroxylapatite with plasma proteins was weak.
