ABSTRACT
This article considers the possibilities of different image acquisition techniques in the study of inflammatory bowel disease, with special emphasis on the roles of tomodensitometry and magnetic resonance imaging. Although these techniques are not superior to barium follow through studies or conventional enteroclysis at depicting the mucosa in detail, they are very useful in the evaluation of the characteristics of the walls of the bowel loops and in the detection of possible extraluminal complications, such as abscesses, adenopathies, and mesenteric involvement. Magnetic resonance shows great potential for the study of the small bowel and is likely to play an important role in the study of inflammatory bowel disease in the near future. This recurring disease affects young patients with long life expectancies in whom exposure to ionizing radiation needs to be minimized. We explain the radiologic findings through a physiopathologic approach to the sequence of events (aphthoid ulcers, fissuring and penetrating ulcerations, formation of fistulous tracts, abscesses, mesenteric involvement) that give rise to them. We propose an objective classification based on the imaging findings that is useful for therapeutic decision making, and we describe the important role of the radiologist in the follow-up as well as in the diagnosis of this entity.
Subject(s)
Colitis, Ulcerative/diagnosis , Crohn Disease/diagnosis , Humans , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
En el presente artículo se consideran las posibilidades de las distintas técnicas de formación de imagen en el estudio de la enfermedad inflamatoria intestinal, con especial referencia al papel desempeñado por la tomodensitometría y la resonancia magnética. Aunque éstas no superan al tránsito baritado o a la enteroclisis convencional en la demostración del detalle mucoso, se muestran muy útiles en la evaluación de las características de la pared de las asas y en la detección de las posibles complicaciones extraluminales: abscesos, adenopatías, afectación mesentérica, etc. La resonancia magnética se presenta con un gran potencial en el estudio del intestino delgado, probablemente en un futuro no lejano desempeñará un importante papel en la evaluación de la enfermedad inflamatoria intestinal, entidad de carácter recurrente, que acaece en pacientes jóvenes, con amplia esperanza de vida, en los que hay que minimizar la exposición a las radiaciones ionizantes. Se presenta un abordaje fisiopatológico de la secuencia de acontecimientos que justifican los hallazgos radiológicos (úlceras aftoides, ulceraciones fisurantes y penetrantes, ulteriores trayectos fistulosos, abscesos, afectación mesentérica, etc.) y se considera una clasificación basada en los hallazgos radiológicos, objetiva, que resulta útil para la toma de decisiones desde el punto de vista terapéutico, justificando así el importante papel que cumple el radiólogo no sólo en el diagnóstico, sino también en el control evolutivo de esta entidad
This article considers the possibilities of different image acquisition techniques in the study of inflammatory bowel disease, with special emphasis on the roles of tomodensitometry and magnetic resonance imaging. Although these techniques are not superior to barium follow through studies or conventional enteroclysis at depicting the mucosa in detail, they are very useful in the evaluation of the characteristics of the walls of the bowel loops and in the detection of possible extraluminal complications, such as abscesses, adenopathies, and mesenteric involvement. Magnetic resonance shows great potential for the study of the small bowel and is likely to play an important role in the study of inflammatory bowel disease in the near future. This recurring disease affects young patients with long life expectancies in whom exposure to ionizing radiation needs to be minimized. We explain the radiologic findings through a physiopathologic approach to the sequence of events (aphthoid ulcers, fissuring and penetrating ulcerations, formation of fistulous tracts, abscesses, mesenteric involvement) that give rise to them. We propose an objective classification based on the imaging findings that is useful for therapeutic decision making, and we describe the important role of the radiologist in the follow-up as well as in the diagnosis of this entity
Subject(s)
Humans , Inflammatory Bowel Diseases/diagnosis , Tomography, X-Ray Computed/methods , Magnetic Resonance Spectroscopy/methods , Crohn Disease/diagnosis , Colitis, Ulcerative/diagnosisABSTRACT
A case of oesophageal neurofibroma is reported; its low incidence among the benign tumours of the oesophagus is pointed out. The clinical, radiologic and histologic features of this very rare tumour are described.