Small-intestinal length measurement on MR enterography: comparison with in vivo surgical measurement.

OBJECTIVE: The purpose of this study is to assess the feasibility and accuracy of small-bowel length measurement on MR enterography examinations compared with surgical in vivo measurements. SUBJECTS AND METHODS: Thirty-one consecutive patients who were undergoing elective laparotomy for Crohn disease were included in the study. These patients underwent a prior MR enterography examination, and true fast imaging with steady-state precession MR enterography images from the examinations were used to measure small-intestinal length. The MR enterography measurement was compared with a surgical measurement to assess accuracy and correlation. RESULTS: MR enterography measurements had a significant positive correlation with surgical measurements (r(2) = 0.98; p < 0.001) irrespective of bowel length. The average (± SD) percentage difference between MR enterography and surgical intestinal length measurement was 4.59% ± 0.44%. An average time of 36.5 ± 2.8 minutes was required for bowel length measurement on MR enterography. A significantly longer time was required for measurement of bowel length greater than 300 cm versus shorter bowel length. CONCLUSION: Small-bowel length measurements on MR enterography are accurate compared with anatomic measurements. MR enterography can provide an effective noninvasive investigation in planning surgical and nutritional intervention in patients with compromised bowel length.

Diffusion-weighted MR imaging of the gastrointestinal tract: technique, indications, and imaging findings.

Diffusion-weighted magnetic resonance (MR) imaging has emerged as an important tool in the diagnostic work-up of patients with bowel cancer and inflammatory conditions of the gastrointestinal tract. It functions on the basis of the microscopic motion of water molecules in a cellular environment and provides functional information about the water in body tissues. Diffusion-weighted imaging serves to complement conventional MR imaging, and its use may improve the accuracy of tumor detection and staging. It does not rely on the use of intravenous contrast material and may be performed in patients with renal impairment. Because it provides quantitative information about tissue cellularity, diffusion-weighted imaging may be used to distinguish between tissues with altered cellularity (eg, tumors and metastases) and normal tissues. Data from diffusion-weighted MR images enable the calculation of apparent diffusion coefficient (ADC) values, which provide useful information about response to treatment. Malignant gastrointestinal tract tumors have low ADC values, which increase after successful therapy. Diffusion-weighted imaging also plays a role in the evaluation of patients with inflammatory bowel disease and may help assess inflammation and complications, such as abscesses and fistulas. Quantitative measurements of signal intensity at diffusion-weighted imaging may help differentiate actively inflamed bowel from normal bowel, and ADC values provide useful information about disease activity and response to treatment.

Associations between adult attachment dimensions and attitudes toward pain behaviour.

BACKGROUND: Despite the important role positive reinforcement of pain behaviour is believed to play in chronic pain, there is a paucity of research regarding factors that influence the provision of such reinforcement. Attachment theory suggests that individuals high in attachment avoidance view the pain behaviour of others in a negative manner and would, therefore, provide little reinforcement of pain behaviour. As an initial step in evaluating this model, relationships between attachment dimensions and attitudes toward pain behaviour were examined. Attachment avoidance was hypothesized to be negatively associated with accepting attitudes toward pain behaviour. METHODS: A sample of undergraduate students (n=160) completed the Relationships Structures Questionnaire, which provides global ratings of adult attachment dimensions (anxiety and avoidance) by assessing attachment across four relationship targets (friend, mother, father and romantic partner). Attitudes regarding the acceptability of pain behaviour were assessed using male and female versions of the Appropriate Pain Behaviour Questionnaire (APBQ). RESULTS: Consistent with the hypothesis, attachment avoidance was negatively correlated with both APBQ-Female and APBQ-Male scores. Multiple regression analyses were used to investigate the relationships between the attachment scales and the APBQ scales while statistically adjusting for sex and testing for interaction effects. The findings revealed complex relationships involving interaction effects that provided further support for the hypothesis. CONCLUSIONS: The findings provided support for the hypothesis that attachment avoidance is associated with less accepting attitudes toward pain behaviour. Additional research regarding the role of attachment and attitudes on responses to pain behaviour is warranted.

Benign mesenteric lymphangioma presenting as acute pancreatitis: a case report.

Benign mesenteric lymphangiomas are rare intra-abdominal cysts which may be asymptomatic or present with a variety of abdominal symptoms including an acute abdomen. We are however not aware of any reports in the literature linking mesenteric lymphangioma to acute pancreatitis. We present the case of a 62-year-old man who was admitted with signs and symptoms of acute pancreatitis and a palpable abdominal mass. Computerised tomography (CT) of his abdomen confirmed the presence of a mesenteric cystic mass. He underwent a laparotomy at which a large thin walled mass filled with a chylous fluid was resected. Histological analysis of this cyst showed it to be a benign mesenteric lymphangioma.

Associations between arthritis and a broad range of psychiatric disorders: findings from a nationally representative sample.

UNLABELLED: Data from the National Epidemiological Study of Alcoholism and Related Conditions (NESARC) were used to investigate associations between arthritis and a wide range of psychiatric disorders in a large sample (n = 43,093) representative of the adult population of the United States. NESARC participants completed the Alcohol Use Disorder and Associated Disabilities Interview Schedule--DSM-IV Version and provided reports regarding medical conditions, including arthritis, experienced over the past year. Logistic regression analyses that adjusted for potential confounding variables (ie, gender, marital status, age, income, and other health conditions) indicated that arthritis had significant positive associations with each of the 7 personality disorders included in the NESARC (ie, avoidant, dependent, obsessive-compulsive, paranoid, schizoid, histrionic, and antisocial). Arthritis also had significant positive associations with mood and anxiety disorders. In contrast to several recent studies indicating arthritis may have relatively larger associations with anxiety disorders than with major depression, the magnitudes of the associations involving anxiety disorders were not particularly large compared with those regarding depressive disorders. Alcohol- and substance-related disorders had negative associations with arthritis. However, additional analyses indicated that age was a confounding variable in these relationships and revealed that arthritis was not associated with either alcohol- or substance-related disorders. PERSPECTIVE: This article presents the first study to investigate associations between arthritis and personality disorders and is the first study to investigate relationships between a condition characterized by pain and personality disorders using a community sample. It may prompt research and clinical attention to the role of personality disorders in arthritis.