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Problemi diagnostici e terapeutici nelle angiodisplasie dell’apparato digerente.
No full text[DIAGNOSTIC AND THERAPEUTIC PROBLEMS IN ANGIODYSPLASIAS OF THE DIGESTIVE TRACT]
After a review of recent literature on angiodysplasias of the digestive system, a diagnostic procedure based on personal experience is proposed for haemorrhagic patients. Criteria for the selection of treatment protocols are then proposed for cases where angiodysplasia is recognised as the cause of the bleeding
The comparison between MRI and MSCT-enteroclysis in the diagnosis of bowel endometriosis
No full textPurpose: To compare the effectiveness of MRI and MSCT-enteroclysis (MSCTe) in determining the presence of bowel endometriosis (BEM) and the depth of bowel wall infiltration of the nodules. Material and methods: We evaluated 26 women (aged 19–38) with signs and symptoms suggestive of colorectal endometriosis. Patients underwent MRI (1T magnet, phased array coil, multiplanar FSET1, T1 fat sat, T2, T1 post-Gado sequences) and MSCTe (16 rows). The exams were reviewed independently by two radiologists. All women underwent laparoscopy within 2 weeks; radiological findings were compared with surgical and histological data. Statistical analysis was performed with SPSS 13.0. Results: The presence of BEM was detected by MRI in 11 (42.3%) women and by MSCTe in 12 (46.2%). Surgery confirmed BEM in 12 patients identified by MSCTe. In the diagnosis, sensibility, specificity, PPV, NPV were 91.7, 100, 100, 93.3% for MRI and 100, 100, 97, 100% for MSCTe. 21 nodules were identified by MRI and 22 by MSCTe; surgery identified 25 nodules: 13 located on the rectum, 11 at sigmoid colon, and 1 at caecum. One false positive nodule was observed at MSCTe. Among correctly identified nodules, MRI estimated the depth of infiltration to the serosa in 8 cases and to the muscularis in 13. At MSCTe, 4 nodules were judged to infiltrate the serosa, 16 to reach the muscularis propria, and 1 the mucosa. MSCTe correctly estimated the depth of nodules infiltration, significantly more frequently than MRI (p=0.048; Fisher‘s exact test). Conclusion: Both MRI and MSCTe reliably detect the BEM nodules; however, MSCTe is more accurate in estimating the depth of infiltration in the bowel wall
Retroperitoneal fibrosis caused by barium: complication of rectal perforation during double contrast enema of the colon. Report of a case
No full textMultidetector-row helical CT enteroclysis.
No full textThe authors illustrate the technique for small-bowel imaging using enteroclysis with multidetector-row computed tomography (MDCT), underscoring the important role played by CT in the assessment of the small bowel thanks to the advent of first the spiral and later the multidetector technique. The paper makes a detailed comparison of the various methods that have been used in CT study of the small bowel and proposes a standardised technique to achieve correct distension of bowel loops and adequate evaluation of bowel wall vascularity, making reference to the well-consolidated experiences of the various Italian research groups. The paper accurately describes the different procedures required for CT assessment of the small bowel, from nasojejunal intubation to the selection of the most appropriate acquisition phases for assessment of bowel wall vascularity
Bowel endometriosis: CT-enteroclysis
No full textAlthough several radiological techniques have been used for the diagnosis of bowel endometriosis, no gold standard is currently established. We used multislice computerized tomography (CT) combined with the distention of the colon by rectal enteroclysis (MSCTe) for the diagnosis of bowel endometriosis. Following bowel preparation, pharmacological hypotonicity, retrograde colonic distention by water enteroclysis, and intravenous injection of iodinated contrast medium, a single volumetric acquisition of the abdomen is performed. MSCTe findings suggestive of bowel endometriosis are the presence of solid nodules with positive enhancement, contiguous or penetrating the colonic wall. When endometriotic lesions are detected, the degree of infiltration of the intestinal wall can be estimated; however, the depth infiltrated by nodules reaching the submucosa may be underestimated. MSCTe is well tolerated by the patients. The strength of MSCT consists in the high spatial resolution; volumetric data acquired by using thin slices provide isotropic voxels and multiplanar reconstructions have a quality comparable with that of the original axial scans. The potential of MSCTe for the diagnosis of bowel endometriosis relies on the fact that the serosal, muscular, and mucosal layers of the bowel wall can be evaluated
Multidetector computerised tomography enteroclysis versus rectal water contrast transvaginal ultrasonography in the diagnosis of bowel endometriosis
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