1,720,975 research outputs found
CT ENTEROGRAPHY WITH POLYETHYLENE GLYCOL SOLUTION VS CT ENTEROCLYSIS IN SMALL BOWEL DISEASE
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CT and MRI Evaluations in Crohn's Complications: A Guide for the Radiologist
No full textInflammatory bowel diseases (IBD) are a group of chronic inflammatory intestinal conditions with unknown etiology. Crohn's disease (CD) and ulcerative colitis (UC) are the two main types of IBD and they have some interchangeable and some different clinical and pathological characteristics. When diagnosis is performed for the first time, the majority of CD patients have a predominant inflammatory condition. As the disease progresses most patients experience the development of complications, such as abscesses, fistulas, perforation, strictures, and others. Both computed tomography (CT) and Magnetic Resonance Imaging (MRI) allow great view of the whole length of the intestinal tract together with the eventual extra-and intra-intestinal complications. MR enterography (MRE) and CT enterography (CTE), performed after oral administrations of contrast medium, have similar diagnostic accuracy for the diagnosis of CD and its complications. Even though CT is still the most familiar diagnostic technique used for studying CD worldwide, MRE have several important benefits that are leading to rapid increase in its employment in the last years. In particular, MRE allows a superior soft tissue contrast resolution compared to CT, offering a better visualization of bowel wall and its inflammatory and fibrotic characteristics. Moreover, Pelvic Magnetic Resonance is the principal technique in patients with perianal disease due to its ability of providing precise and fine detail images of the sphincter complex, which are crucial for evaluating pelvic disease. In this paper we describe common and uncommon complications in patients with CD, and explain how to identify their findings in CT and MR exams
Magnetic Resonance Enteroclysis imaging of Crohn's
No full textThe aim of our prospective study was to evaluate the diagnostic accuracy of MR Enteroclysis (MRE) to assess the extension and complications of Crohn's Disease (CD) in comparison with conventional enteroclysis (CE)
The accuracy of voiding urosonography in detecting vesico-ureteral reflux: a summary of existing data.
No full textThe primary objective of this review was to assess the diagnostic accuracy of voiding urosonography (VUS) in detecting reflux (VUR). As a secondary objective, the reported technical suggestions and diagnostic mistakes were shown to improve the examination protocol and provide the most accurate results. Using a Medline Database search, the published articles comparing the grey-scale (GS) or colour-Doppler (CD) VUS with voiding cystourethrography (VCUG) as the gold standard were selected. Articles were excluded when data were not sufficient to construct 2x2 tables or when the gold standard was different from VCUG. For the analyses of diagnostic accuracy values, 95% confidence intervals were given. Agreements in the results of GSVUS and VCUG and in those of CDVUS and VCUG were determined by Kappa statistics. GSVUS and CDVUS were compared for diagnostic accuracy by the McNemar test. Results showed that the range of GSVUS sensitivity and specificity in detecting VUR was 69%-100% and 86%-97%, respectively. The agreement between GSVUS and VCUG diagnoses ranged from 90% to 97% (K score range 0.61-0.92; P<0.001). The range of CDVUS sensitivity and specificity in detecting VUR was 93%-100% and 86%-93%, respectively. The agreement between CDVUS and VCUG diagnoses ranged from 89% to 96% (K score range 0.77-0.91; P<0.001). One study comparing both VUS modalities with VCUG in the same group of patients, showed that the diagnostic accuracy of CDVUS was significantly higher than that of GSVUS (96% versus 90% of cases correctly classified; McNemar chi squared =4; P<0.05).
CONCLUSION:
the existing data indicate that false-negative voiding urosonographic diagnoses (8%-31%) and underestimated reflux grading cases using the same technique are related to anatomical conditions, patient cooperation and contrast medium administration. False-positive (3%-14%) and overestimated reflux grading cases using voiding urosonography could be correctly assessed cases. The intermittent nature of vesico-ureteral reflux is better detected by a technique employing a prolonged observation time, such as voiding urosonography. This might question the current role of voiding cystourethrography in the investigation of reflux
Assessment of Crohn's Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations
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Combined diagnostic imaging of Crohn's disease: an outlook
No full textCrohn's disease is an inflammatory disease of the mucosa and bowel wall layers involving peritoneal, mesenteric structures and lymph nodes. The combination of the various imaging procedures plays a major role in the evaluation of Crohn's disease patients, based on which an optimal definition of the disease stage is achieved. This is required for a correct therapeutic strategy that can be exclusively medical, surgical or elective in complications. In the combined approach, the follow-through study of the small bowel and enteroclysis in particular, represents the examination of choice to document the early disease, early signs of recurrence with the demonstration of all mucosal alterations, including fistulous tracts. Sonography, CT and MRI allow the evaluation of Crohn's location in the wall and adjacent region. Preliminary results of CT-enteroclysis and MR-enteroclysis seem able to document mucosal alterations and morphofunctional characteristics In the near future these new examinations could become a real one-stop-shop coupled with wireless endoscopy in the study of Crohn's disease
Contrast-enhanced Voiding US for Grading of Reflux in Adult Patients Prior to Antireflux Ureteral Implantation1
No full textPURPOSE: To prospectively assess contrast material–enhanced voiding ultrasonography
(US) for grading of vesicoureteral reflux (VUR) and to compare results with
those of voiding cystourethrography (VCUG) in adult patients undergoing antireflux
ureteral implantation.
MATERIALS AND METHODS: Thirty-seven consecutive adult patients who had
undergone renal transplantation with Politano-Leadbetter (18 patients) or Lich-
Gregoire (19 patients) technique were included on the basis of previous urinary tract
infections (UTIs) and time elapsed after renal transplantation. Exclusion criterion was
current UTI. US was performed by one of two sonologists with injection of saline and
microbubble suspension and was recorded on videotape. Sonologists assigned VUR
diagnosis in consensus after videotape review. VCUG was performed by one of two
radiologists immediately after US. Radiologists were blinded to US findings and
assigned VCUG diagnoses in consensus. Contingency table was used to compare US
and VCUG. Agreement between US and VCUG was determined with statistics.
RESULTS: With VCUG, VUR was diagnosed in 15 patients and not diagnosed in 22
patients. US and VCUG results were in agreement in 14 patients with VUR and 21
patients without VUR. US sensitivity and specificity for detection of VUR were 93%
(14 true-positive results in 15 abnormal cases) and 95% (21 true-negative results in
22 normal cases), respectively. Agreement between US and VCUG was 95% (0.89,
P .001). In 11 of 14 patients, VUR grades were in agreement for US and VCUG. In
three of 14 patients, US indicated a higher grade than did VCUG. VUR was diagnosed
in seven of 18 Politano-Leadbetter cases and eight of 19 Lich-Gregoire cases.
CONCLUSION: A high rate of agreement was seen between voiding US and VCUG
The state of the art of small bowel imaging: combine the old with the new
No full textBarium contrast examinations are the reference methods for the detection of morphological intraluminal alterations of the small bowel. Oral small bowel examination in many Centers has been replaced by small bowel enteroclysis. It allows optimal filling of intestinal loops, through a nasojejunal tube and the diagnostic sensitivity and specificity are higher as compared to the conventional examination. US, CT and MRI are useful diagnostic procedures in the evaluation of parietal and extraparietal alterations and in the study of complications of small bowel disease. In recent years, CT-enteroclysis and MR-enteroclysis have been developed, both enable the evaluation of luminal, extraluminal and mural alterations of the small bowel. Diagnostic imaging plays a major role in the study of the small bowel. The most appropriate diagnostic method should be selected, based on the clinical observations and on the availability of the technique
Comparison between clinical and radiological evaluation before and after medical therapy in patients with Crohn's disease: new prospective roles of CT enterography
No full textIn recent years, CT enterography (CTE) has emerged as an important methodology to study patients with Crohn's disease (CD). The aim of this study was to evaluate the correlation between clinical response to therapy and CTE findings in CD patients
How the Radiologist Must Reason for a Correct Diagnosis in Patients With Small Bowel Mural Thickening Studied by CT or MRI: A Pictorial Review
No full textConditions that lead to small bowel mural thickening fall into a broad spectrum of diseases, including inflammatory, infectious, vascular or neoplastic. Computed tomography (CT) and Magnetic Resonance Imaging (MRI), especially CT-enterography and MR-enterography, permit evaluation of both entire small bowel and extraluminal structures. In CT/MR-enterography, the main prerequisite for the correct evaluation of small bowel is to obtain optimal intestinal distension. In fact, most errors are related to poor intestinal distension of the bowel which can lead to interpret as pathological a small bowel segment that is not very distended (false positive), or not to recognize presence of pathology in a collapsed segment (false negative). Once the examination has been performed, the images are analyzed in order to identify the presence of small bowel pathology. Pathology of the small bowel can manifest as endoluminal alteration and/or intestinal wall thickening. Once bowel wall thickening has been identified, the radiologist's first objective is trying to define benign or malignant nature of the alteration, using also patient's history and clinical features. Once the suspicion of benign or malignant pathology has been raised, the radiologist must try to formulate a diagnosis of nature. In this pictorial review we describe how the radiologist must reason for a correct diagnosis by answering a pattern of sequential questions in a patient with suspected small bowel disease studied by CT or MRI. (c) 2023 Published by Elsevier Inc
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