共查询到20条相似文献,搜索用时 31 毫秒
1.
Andrea Rieber D. Wruk K. Nüssle A. J. Aschoff M. Reinshagen G. Adler H.-J. Brambs R. Tomczak 《Der Radiologe》1998,38(1):23-28
Summary
In spite of the improved MR-diagnosis of the abdomen, MRI is not used as a routine method for the diagnosis of inflammatory
small bowel disease. The aim of this study was – after optimazation of the bowel opacification – the correlation of the findings
obtained with enteroclysis and MRI in patients with known Crohns' disease.
60 patients beween 17 and 72 years of age were investigated. First, an enteroclysis was performed in typical manner. The applicated
methylcellulosis was blended with positive oral MR contrast media (Magnevist oral, Schering). After enteroclysis, MRI of the
abdomen was performed using T1- and T2-weighted breathhold sequences (Flash 2D pre- and postcontrast and TSE) in axial and
coronal planes.
The lenght of the affected bowel and the stenosis seen with enteroclysis correlated well with the visible thickening of the
small bowel wall and the stenosis seen in MRI. Using MRI, additional findings could be obtained in 28 patients, such as fistulas,
abscesses or a hydronephrosis, or a better assessment of the stenosis was possible with MRI, because of the avoidance of overshadowing
of the affected bowel loop with MRI.
A brilliant MR-tomographic imaging of the small bowel is possible under the condition, that the small bowel contrast is optimal.
The main prerequisite is a large filling volume of the small bowel to reach a homogeneous contrast and a good distension of
the small bowel lumen.
相似文献
2.
Breathhold MRI of the small bowel in Crohn's disease after enteroklysis with oral magnetic particles
N. Holzknecht T. Helmberger C. von Ritter J. Gauger S. Faber M. Reiser 《Der Radiologe》1998,38(1):29-36
Purpose: To evaluate the efficacy of breathhold MRI following enteroclysis with addition of oral magnetic particles to study the extension,
detection of stenoses and extraluminal manifestations in Crohn's disease.
Material and Methods: 18 patients with Crohn's disease and potential of surgical intervention were studied with enteroclysis with addition of oral
magnetic particles. T1-/T2-weighted breathhold MRI w/o spectral fat suppression w/o i. v. Gd-DTPA was applied.
Results: Typical findings were marked bowel wall thickening with strong contrast enhancement. 95.8 % of affected small bowel segments
and 94.7 % of stenoses were correctly detected by MRI. All four fistulas were detected and important extraluminal findings
were seen in 6/18 patients. Additionally, one ileoileal and two ileosigmoidal adhesions, two extraluminal abscesses and affection
of the right ureter were delineated.
Conclusion: MRI in Crohn's disease offers the potential to avoid radiation exposure in this relatively young patient group. Important
additional findings relevant to indication of surgery are seen in approximately one third of cases. The replacement of transduodenal
intubation by oral contrast application remains to be further studied.
相似文献
3.
PURPOSE: To compare the efficacy and quality of conventional and MR enteroclysis with different filling methods regarding the assessment of extension and extraluminal manifestations in Crohn's disease. MATERIAL AND METHODS: 190 patients with known Crohn's disease were studied following small bowel enteroclysis, after oral administration or direct transduodenal filling in the MRI-department.T1- and T2-weighted breathhold MRI-scans w/o spectral fat suppression w/o i.v. Gd-DTPA were applied using negative oral superparamagnetic contrast media. RESULTS: Typical findings were marked bowel wall thickening with laminated wall contrast enhancement. In 135 patients 98,2% of affected bowel segments, 97,5% of stenoses and all 16 fistulas were detected, when conventional enteroclysis was employed as standard of reference. Additional important extraluminal findings such as ileoileal (n = 18), ileosigmoidal adhesions (n = 12), extraluminal abscesses (n = 35) and pseudotumors (n = 8) were visualized in 73/135 patients. Concerning the distension of jejunum and ileum, oral filling was rated significantly inferior to transduodenal filling in all small bowel segments,whereas filling in the MRI-unit was rated superior to fluoroscopic, mostly due to a mean transport time of 20 min to the MRI-unit. CONCLUSION: No clinically important findings of enteroclysis were missed when using MRI. Therefore, in patients with Crohn's disease, conventional enteroclysis can be replaced by MRI. For optimal bowel distension oral contrast administration is inferior to transduodenal filling, if a larger time delay between filling and the MRI-scan can be avoided. 相似文献
4.
Imaging of small bowel Crohn's disease: can abdominal CT replace barium radiography? 总被引:2,自引:0,他引:2
D. D. T. Maglinte R. L. Hallett D. Rex G. T. Chua F. M. Kelvin B. Harmon J. Lappas 《Emergency radiology》2001,8(3):127-133
Objectives: To analyze imaging features and compare the diagnostic information provided by abdominal computed tomography (CT) and enteroclysis
to see whether CT can replace barium examinations in the assessment of patients with small bowel Crohn's disease. Methods: The abdominal CT studies and enteroclysis of 33 patients with small bowel Crohn's disease who underwent both examinations
within a 2-week time period were retrospectively reviewed and scored for the presence and severity of the following features:
mural edema, ulceration, small bowel obstruction, stricture, sinus tract formation, fistula, abscess, extraintestinal manifestations,
and total number of intestinal sites involved. The statistical significance of the differences for each variable was calculated.
Results: A total of 37 case sets were reviewed. CT demonstrated 10 (27 %) abscesses compared to 7 (19 %) shown by enteroclysis. Three
extraintestinal sites shown by CT were not demonstrated by enteroclysis. Enteroclysis detected a larger number of intestinal
sites of involvement (54 vs. 47) and more cases of ulceration (78 % vs. 19 %), small bowel obstruction (46 % vs. 16 %), stricture
(38 % vs. 11 %), fistula formation (24 % vs. 8 %), and sinus tract formation (27 % vs. 5 %). The two modalities were similar
in characterizing and grading the severity of mural thickening (CT showed 41 %, enteroclysis 46 %). Conclusion: Abdominal CT and enteroclysis provide unique and complementary diagnostic information in patients with Crohn's disease of
the small bowel. Both methods may be required for the accurate assessment of the severity and extent of Crohn's disease of
the small bowel. The choice of initial examination will depend on the clinical issue in question. 相似文献
5.
Blueberry juice used per os in upper abdominal MR imaging: composition and initial clinical data 总被引:2,自引:0,他引:2
Karantanas AH Papanikolaou N Kalef-Ezra J Challa A Gourtsoyiannis N 《European radiology》2000,10(6):909-913
The aim of this study was to evaluate the use of a commercially available blueberry juice (BJ) both as a positive and negative
oral contrast agent and to present the exact contents of paramagnetic ions. The concentration of Mn and Fe were determined
in tinned myrtilles in syrup (atomic absorption). Nine healthy volunteers and 12 patients (age range 20–65 years) were examined
using a 1-T MR scanner before and after per os administration of 430 ml of BJ. A qualitative analysis of signal alterations
in the stomach, duodenum, and proximal small intestine was performed. In addition, a quantitative analysis was assessed in
terms of signal-to-noise ratio calculation. The mean concentration ( ×± SD) of the ions found in the content of the three
cans were 3.3 ± 0.4 μg/g for iron and 20.6 ± 2.6 μg/g for manganese. Based on the qualitative evaluation, signal alteration
on T1-weighted images after administration of BJ was statistically significant in the stomach and duodenum, but not in the
proximal small bowel. Signal alteration on T2-weighted images was not statistically significant in any part of the gastrointestinal
tract. The quantitative analysis of the T1- and T2 shortening showed that BJ is efficient with only T1-weighted sequences,
and this applied to the stomach, duodenum, and proximal small bowel. Blueberry juice can be used as an oral contrast agent
in upper abdominal MR for T1-weighted imaging.
Received: 7 September 1999; Revised: 29 November 1999; Accepted: 16 February 2000 相似文献
6.
Multifocal nodular fatty infiltration of the liver mimicking metastatic disease on CT: imaging findings and diagnosis using MR imaging 总被引:1,自引:0,他引:1
Kröncke TJ Taupitz M Kivelitz D Scheer I Daberkow U Rudolph B Hamm B 《European radiology》2000,10(7):1095-1100
The aim of this study was to describe the MR appearance of multifocal nodular fatty infiltration of the liver (MNFIL) using
T1-weighted in-phase (IP) and opposed-phase (OP) gradient-echo as well as T2-weighted turbo-spin-echo sequences with fat suppression
(FSTSE) and without (HASTE). Magnetic resonance imaging examinations at 1.5 T using T1-weighted IP and OP-GRE with fast low
angle shot (FLASH) technique, and T2-weighted FSTSE, T2-weighted HASTE of 137 patients undergoing evaluation for focal liver
lesions were reviewed. Five patients were identified in whom CT indicated metastatic disease; however, no liver malignancy
was finally proven. Diagnosis was confirmed by biopsy (n = 3), additional wedge resection (n = 1) or follow-up MRI 6–12 months later (n = 5). Regarding the identified five patients, the number of focal liver lesions was 2 (n = 2) and more than 20 (n = 3). The MR imaging characteristics were as follows: OP-image: markedly hypointense (n = 5); IP image: isointense (n = 2) or slightly hyperintense (n = 3); T2-weighted FSTSE-image: isointense (n = 5); T2-weighted HASTE image isointense (n = 1); slightly hyperintense (n = 4). On OP images all lesions were sharply demarcated and of almost spherical configuration (n = 5). Further evaluation by histology or follow-up MR imaging did not give evidence of malignancy in any case. Histology
revealed fatty infiltration of the liver parenchyma in three patients. Magnetic resonance follow-up showed complete resolution
in two patients and no change in three patients. Multifocal nodular fatty infiltration can simulate metastatic disease on
both CT and MR imaging. The combination of in-phase (IP) and opposed-phase (OP) gradient-echo imaging can reliably differentiate
MNFIL from metastatic disease.
Received: 15 September 1999 Revised: 3 February 2000; Accepted: 7 February 2000 相似文献
7.
The objective of this retrospective study was to compare MRI of the abdomen with ultrasound of the abdomen and gastrointestinal tract in patients with Crohn's disease. Forty-six patients were included in the study. We analyzed the localization of Crohn's lesions, the number of affected bowel segments, the number of stenoses, and the presence of abscesses, fistulae, and any additional findings. Findings were verified by means of one or more of the following: enteroclysis; surgical findings; and colonoscopy. The results show that MRI is superior to ultrasound in the localization of affected bowel segments (sensitivity: MRI 97.5%; US 76%) and in recognizing fistulae (sensitivity: MRI 87%; US 31%), stenoses (sensitivity: MRI 100%; US 58%) and abscesses (sensitivity: MRI 100%; US 89%). Magnetic resonance imaging of the abdomen should be obtained to clarify discrepant clinical and sonographic findings. In addition, despite its higher cost, MRI of the abdomen is justified in patients in whom Crohn's lesions are known or suspected in anatomic areas proximal to the terminal or neoterminal ileum and in cases with suspicion of fistulae and abscesses. 相似文献
8.
Accuracy of enteroclysis in Crohn's disease of the small bowel: a retrospective study 总被引:3,自引:3,他引:0
Cirillo LC Camera L Della Noce M Castiglione F Mazzacca G Salvatore M 《European radiology》2000,10(12):1894-1898
The aim of this study was to evaluate the accuracy of enteroclysis in the diagnosis of Crohn's disease of the small bowel
in a group of consecutive patients. From January 1992 to December 1995, 165 patients with suspected Crohn's disease of the
small bowel presented to our institution for enteroclysis. In 14 patients up to three enteroclysis exams were performed. Most
patients (78 %) underwent colonoscopy and retrograde ileoscopy. In the remaining patients clinical follow-up was used as gold
standard. In 79 patients no radiographic abnormalities were found. Sixty-one patients (40 men and 21 women; mean age 34.2
years) had a radiological diagnosis of Crohn's disease. This involved the terminal ileum in 39 patients (64 %) either alone
(n = 25) or in association with the pelvic ileum (n = 14). In 12 of these patients retrograde ileoscopy was not feasible. Twenty-one patients underwent surgery. In 4 patients
pathology revealed diseases other than Crohn's. These patients had all ileocecal diseases (tuberculosis = 2; non-Hodgkin's
lymphoma = 1; adenocarcinoma = 1). One false-negative result was observed. Overall, enteroclysis showed a sensitivity of 98.2
% and a positive predictive value of 93.4 %. Enteroclysis is a sensitive technique in evaluating both the extent and the severity
of small bowel involvement in Crohn's disease, although the overlap of radiographic findings may hamper its accuracy when
the disease is confined to the ileocecal area.
Received: 25 November 1999; Revised: 4 April 2000; Accepted: 6 April 2000 相似文献
9.
MRI in Crohn's disease 总被引:9,自引:0,他引:9
Technological developments have extended the role of MRI in the evaluation of the gastrointestinal tract. The potential of MRI to evaluate disease activity in Crohn's disease has been investigated extensively, as MRI has intrinsic advantages over other techniques, including noninvasiveness and the absence of ionizing radiation. For perianal fistulizing disease MRI has become a mainstay in evaluation of disease, as localization and extent of disease can be very well appreciated using both T2-weighted and T1-weighted sequences, fat suppression, and intravenous contrast medium. Imaging of the small bowel and colon in Crohn's disease is more complicated due to bowel peristalsis and respiratory movement. However, using fast breathhold sequences and intravenous spasmolytic medication, images of good diagnostic quality can be acquired. To obtain sufficiently distended bowel, which in our estimation is a prerequisite for evaluation of the bowel, MR enteroclysis can be performed. However, applicability of different oral contrast media has been studied, as a noninvasive method for bowel distension would be preferable. Abdominal MRI is a valuable imaging technique for evaluation of luminal, transmural, and extraintestinal manifestations of Crohn's disease as degree of disease activity, presence of luminal pathology (e.g., stenoses), and extraintestinal manifestations of disease (e.g., abscesses, fistulas) can be accurately assessed. 相似文献
10.
Savnik A Amris K Røgind H Prip K Danneskiold-Samsøe B Bojsen-Møller F Bartels EM Bliddal H Boesen J Egund N 《European radiology》2000,10(10):1655-1659
Falanga is an ancient form of punishment or torture but is still commonly reported by our refugees. The late result of caning
the heel and ball of the foot is a chronic painful condition with few clinical signs. The aim of the present study was to
assess, by MRI, possible morphologic characteristics of the heel and ball of the foot, related to falanga and pain in correlation
to clinical findings. Magnetic resonance imaging of the foot was obtained in 12 victims exposed to falanga torture and 9 healthy
volunteers. Sagittal T1-weighted spin-echo images (TR 616–840 ms, TE 20 ms), T2-weighted spin-echo images (TR 1900 ms, TE
90 ms), and short tau inversion recovery (STIR) images (TR 1200 ms, TE 15 ms, TI 100 ms) were performed. The central portion
of the plantar aponeurosis was generally significantly thicker in victims exposed to falanga torture as compared with that
of controls (P < 0.05). In all except one of the victims, MRI demonstrated two layers of the thickened plantar aponeurosis: a deeper portion
with normal homogeneous low signal intensity (SI) appearance, and a superficial layer with characteristic areas of mixed SI
on both T1- and T2-weighted images. There were no signs of chronic muscular compartment syndromes, and the thickness of the
plantar pad did not differ between the two groups. Magnetic resonance imaging may demonstrate morphologic characteristics
of the plantar aponeurosis which may confirm falanga torture. Further imaging with more specific sequences is warranted to
demonstrate the supposed injuries in the compartmental fat tissue chambers and the vascularity of the ball pad of the foot.
Received: 25 November 1999; Revised: 8 February 2000; Accepted: 6 April 2000 相似文献
11.
Purpose: Today patients with suspected diverticulitis are commonly imaged with a CT scan utilizing a variety of methods of contrast
medium administration. Although CT with rectally administered colon contrast has demonstrated a high diagnostic accuracy,
concerns have been raised over its safety in patients with diverticulitis. The following retrospective investigation was undertaken
to answer this concern. Materials and methods: Between January, 1997, and July, 1999, 308 patients with suspected diverticulitis were examined in the Emergency Radiology
Division of the Massachusetts General Hospital by means of a helical CT scan performed with rectally administered colon contrast
material. The patients' CT findings were correlated with their clinical courses and/or surgical findings. Results: Of the 308 CT scans, 115 (37.3 %) were positive for diverticulitis. Of 193 patients without diverticulitis, 91 (47.1 % of
patients without diverticulitis) had alternative diagnoses made by CT, such as small bowel obstruction, epiploic appendagitis,
and urinary tract calculi. No complications due to colon contrast material were noted. Even in cases where there was free
extraluminal air, no extravasated contrast material was seen. Rectally administered colon contrast was well tolerated by patients
and provided excellent large bowel opacification. This method saved imaging time in an emergency setting, as there was no
need to wait for oral contrast to reach the colon. Conclusion: Out of 308 CT scans, there were no complications from the use of rectally administered colon contrast material. No case of
traumatic bowel perforation secondary to colon contrast material was observed. Rectally administered colon contrast material
is safe in the CT examination of patients with suspected diverticulitis. 相似文献
12.
Negaard A Paulsen V Sandvik L Berstad AE Borthne A Try K Lygren I Storaas T Klow NE 《European radiology》2007,17(9):2294-2301
The aim was to compare bowel distension and diagnostic properties of magnetic resonance imaging of the small bowel with oral
contrast (MRI per OS) with magnetic resonance enteroclysis (MRE). Forty patients with suspected Crohn’s disease (CD) were
examined with both MRI methods. MRI per OS was performed with a 6% mannitol solution and MRE with nasojejunal intubation and
a polyethylenglycol solution. MRI protocol consisted of balanced fast field echo (B-FFE), T2 and T1 sequences with and without
gadolinium. Two experienced radiologists individually evaluated bowel distension and pathological findings including wall
thickness (BWT), contrast enhancement (BWE), ulcer (BWU), stenosis (BWS) and edema (EDM). The diameter of the small bowel
was smaller with MRI per OS than with MRE (difference jejunum: 0.55 cm, p < 0.001; ileum: 0.35 cm, p < 0.001, terminal ileum:
0.09 cm, p = 0.08). However, CD was diagnosed with high diagnostic accuracy (sensitivity, specificity, positive and negative
predictive values: MRI per OS 88%, 89%, 89%, 89%; MRE 88%, 84%, 82%, 89%) and inter-observer agreement (MRI per OS k = 0.95;
MRE k = 1). In conclusion, bowel distension was inferior in MRI per OS compared to MRE. However, both methods diagnosed CD
with a high diagnostic accuracy and reproducibility. 相似文献
13.
Comparative efficacy of and sequence choice for two oral contrast agents used during MR imaging. 总被引:2,自引:0,他引:2
S Grubnic A R Padhani P B Revell J E Husband 《AJR. American journal of roentgenology》1999,173(1):173-178
OBJECTIVE: Our objective was to compare the efficacy of a positive and a negative oral contrast agent and to determine the optimal sequence choice for use in pelvic MR imaging. SUBJECTS AND METHODS: We undertook a prospective randomized trial of 57 patients with pelvic cancer who were examined with MR imaging after oral administration of a positive contrast agent (27 patients) or a negative contrast agent (30 patients). T1- and T2-weighted breath-hold and non-breath-hold gradient-recalled echo and turbo spin-echo sequences were obtained. Using the hard-copy images, we graded filling and distention of the small bowel, bowel wall conspicuity, delineation of normal and pathologic structures, and artifacts. RESULTS: Good or excellent small-bowel filling and distention was obtained in 17 patients (63%) receiving the positive agent and in 26 patients (87%) receiving the negative agent, and bowel wall conspicuity was graded good or excellent in 19 patients (70%) and 20 patients (67%), respectively. Normal and pathologic structures were better delineated with the negative agent (20 patients [74%] and 27 patients [90%], respectively; p = .02). Breath-hold gradient-recalled echo T1-weighted images were preferred for the positive agent (78%), and breath-hold T2-weighted images were preferred for the negative agent (93%). Contrast artifacts were more frequently seen with the negative agent (11% and 93%, respectively; p = .0001), and such artifacts were eliminated using T2-weighted sequences. CONCLUSION: Both contrast agents were effective in pelvic MR imaging, but delineation of normal and pathologic structures was better with the negative agent. Gradient-recalled echo T1-weighted sequences are recommended for positive contrast agents, and breath-hold T2-weighted sequences are recommended for negative contrast agents. 相似文献
14.
The purpose of this study was to determine the value of MR imaging for the demonstration of masses in the tongue and floor
of the mouth. Nine patients were prospectively examined with MR imaging after physical examination. Imaging protocol included
T2 and contrast-enhanced and non-contrast-enhanced T1-weighted turbo spin-echo sequences, and the findings were compared with
surgical and histopathological results. Histopathological examination revealed four squamous cell carcinomas, one adenoid
cystic carcinoma, two tongue abscesses, and one chronic inflammatory change. The other case was diagnosed as hemangioma depending
on clinical and imaging findings alone. In cases with squamous cell carcinoma, staging was done on the basis of MR imaging
findings, and was found to be T4 in two cases, T3 in one case, and T2 in another. The primary role of MR imaging of the tongue
and oropharynx is not to make a tissue diagnosis. Multiple deep biopsies are mandatory for the differentiation of other inflammatory
and neoplastic lesions. Magnetic resonance imaging produces coronal and sagittal image planes to assess the volume and spread
of the lesion and helps the surgeon determine the direction in which the biopsy should be performed.
Received: 4 October 1999; Revised: 31 January 2000; Accepted: 6 April 2000 相似文献
15.
Purpose: Identification of the degree of small bowel obstruction (SBO) is helpful in patient management decisions since the treatment
of partial SBO is nonoperative, whereas the treatment of complete SBO requires surgical intervention. We describe a technique
providing the benefits of CT and enteroclysis together, which allows the radiologist to determine the degree of the SBO and
thereby to distinguish partial from complete SBO. Methods and materials: Abdominal CT scans were performed on 21 patients. Patients were given 200 ml concentrated oral contrast medium. Serial radiographs
followed the progression of contrast at 1, 3, and 5 h in order to optimize the timing of the abdominal CT. A partial SBO was
diagnosed if the oral contrast reached the colon at or before the 5-h film, and a complete SBO if the oral contrast did not
reach the colon by the 5-h abdominal radiograph. The CT was performed when the contrast reached the colon or after the 5-h
film. Results: CT findings demonstrated complete obstruction in eight patients, all of whom required surgical treatment. Partial SBO was
demonstrated in 13 patients. Ten of the 13 patients with partial SBO had an uncomplicated transition zone, probably due to
adhesions, and were treated medically. Nine of these patients were managed with nasogastric tube decompression and were discharged
without surgical intervention. One patient failed to respond to a 12-h course of nasogastric tube decompression and underwent
lysis of adhesions. Three of the 13 patients had a complicated transition zone, due to an intussusception and two hernias,
which were responsible for the SBO. Two were treated surgically and one medically. Conclusion: The use of small-volume hyperosmolar abdominal CT allows the radiologist to determine the degree of the SBO. This additional
information is very useful in patient management because uncomplicated partial SBO is often treated successfully via tube
decompression, whereas complete SBO requires surgical intervention. 相似文献
16.
Tumors of the cardiac valves: imaging findings in magnetic resonance imaging, electron beam computed tomography, and echocardiography 总被引:2,自引:0,他引:2
Wintersperger BJ Becker CR Gulbins H Knez A Bruening R Heuck A Reiser MF 《European radiology》2000,10(3):443-449
We describe the findings from various cross-sectional imaging modalities in patients with cardiac valve adherent masses.
The techniques are discussed, and imaging findings are compared with the results of cardiac surgery. All three patients had
neurological symptoms and/or cardiac murmurs. Transthoracic and/or transesophageal echocardiography revealed the cardiac mass
in all three. For differentiation of thrombus and cardiac neoplasm magnetic resonance imaging (MRI) was also performed in
all three patients and electron-beam computed tomography (EBCT) in two. Fast segmented cine gradient-echo MRI techniques provided
mass depiction in all patients, while T1-weighted spin-echo imaging failed in mass detection in one patient. None of the patients
showed evidence of valve regurgitation or stenosis in flow sensitive cine MRI. EBCT excluded mass calcifications in both patients
and reliably demonstrated the valve attached lesions. Although echocardiography is the modality of choice in evaluating cardiac
masses and especially valve attached masses, MRI and EBCT provide additional information about tissue characteristics and
allows an excellent overview of the cardiac and paracardiac morphology. Fast segmented cine gradient-echo MRI is especially
able to depict even small tumors attached to rapidly moving cardiac valves, and valve competence can be easily assessed within
the same examination.
Received: 17 December 1998; Revision received: 1 June 1999; Accepted: 10 August 1999 相似文献
17.
Dave-Verma H Moore S Singh A Martins N Zawacki J 《Current problems in diagnostic radiology》2008,37(6):279-287
Computed tomographic (CT) enterography and enteroclysis improve visualization of the small bowel mucosa and wall in comparison with traditional CT and fluoroscopic studies by distending the small bowel through enteric hyperhydration with a negative contrast agent. Although CT enterography is performed with oral hyperhydration, CT enteroclysis requires the placement of an enteroclysis tube, often in patients who are unable to orally consume the amount of liquid. When tolerated, CT enterography is often preferred due to its lack of invasiveness. Magnetic resonance enterography and enteroclysis are other modalities that are still being studied and show promise in the imaging of small bowel. Unlike small bowel follow-through, conventional enteroclysis, or capsule endoscopy, extraenteric findings are best assessed on CT enterography. These include findings in the surrounding mesentery, perienteric fat, and the adjacent solid organs that may be associated with the small bowel process and include fistulas or abscesses, mural hyperenhancement, prominent vasa recta, and other inflammatory changes. CT enterography has developed into the first-line modality in the imaging of Crohn's disease and is considered the most appropriate imaging modality in patients with suspected Crohn's disease. It is also increasingly being used in the assessment of small bowel infections, neoplasms, adhesions, and polyps. 相似文献
18.
Role of radiology in the diagnosis of neurosarcoidosis 总被引:2,自引:0,他引:2
Clinical studies report a rate of 5 % and autopsy results a rate of 25 % of brain involvement in sarcoidosis. The aim of
this study was to evaluate the role of radiology in the diagnosis of patients with neurosarcoidosis. The chest radiographs
and MRI brain scans of 22 patients with sarcoidosis were retrospectively reviewed, along with the information that was provided
in the request form and clinical charts. All patients had neurological signs and symptoms; 21 patients were examined with
contrast enhancement. Facial nerve paralysis was the most common clinical manifestation identified in 10 patients. A wide
spectrum of MR findings was noted: periventricular high-signal lesions on T2-weighted images (46 %); multiple supratentorial
and infratentorial brain lesions (36 %); solitary intra-axial mass (9 %); solitary extra-axial mass (5 %); and leptomeningeal
enhancement (36 %). Neurological signs and symptoms can be significant manifestations of sarcoidosis. Magnetic resonance imaging
shows a wide spectrum of brain abnormalities associated with neurosarcoidosis. The patient's history and chest X-ray are helpful
in arriving at the correct diagnosis, but in selected cases with isolated brain involvement biopsy may still be required.
Received: 21 June 1999; Revised: 27 August 1999; Accepted: 15 October 1999 相似文献
19.
Discriminatory power of MRI for differentiation of adrenal non-adenomas vs adenomas evaluated by means of ROC analysis: Can biopsy be obviated? 总被引:2,自引:0,他引:2
Slapa RZ Jakubowski W Januszewicz A Kasperlik-Zaluska AA Dabrowska E Fijuth J Feltynowski T Tarnawski R Królicki L 《European radiology》2000,10(1):95-104
The purpose of our study was to evaluate the discriminatory power of MRI in high-field magnet (1.5 T) for differentiation
of adrenal non-adenomas vs adenomas assessing the following parameters separately and in combination: mean diameter of adrenal
mass; previously described and new ratios as well as index calculated from signal intensity (SI) on SE T2-weighted images,
chemical shift imaging (CSI), and Gd-DTPA-enhanced dynamic studies. One hundred eight adrenal masses (36 non-hyperfunctioning
adenomas, 27 pheochromocytomas, 23 aldosterone-secreting adenomas, 20 malignant masses and 2 cortisol-secreting adenomas)
in 95 patients were evaluated with SE sequences, CSI and Gd-DTPA dynamic studies. Indices and ratios of SI for all examined
MRI methods were calculated and examined retrospectively for significance of differences between the groups with calculation
of sensitivity and specificity. Receiver operating characteristics (ROC) analysis of calculated parameters in combination
was performed. The multifactorial analysis of all four parameters, including size of the tumor, T2liver index, CSI ratio reflecting lipid content in the tumor and Womax/last ratio reflecting maximal washout of contrast agent from the tumor had 100 % sensitivity and 100 % specificity in characterization
of adrenal non-adenoma. The best performance of combination of mean tumor diameter with single MRI SI parameter was achieved
in combination with T2liver index for all adrenal masses (area under ROC 0.987) and CSI ratio for non-hyperfunctioning adrenal masses (area under ROC
0.991). Magnetic resonance imaging enables sensitive and specific diagnosis of adrenal non-adenoma.
Received: 18 June 1998; Revised: 11 January 1999; Accepted: 5 May 1999 相似文献
20.
Mariko Hosono H. Kobayashi Ryota Fujimoto Kazushige Tsutsui Yoshihiko Kotoura Tadao Tsuboyama Hikaru Hayashi Takashi Nakamura Junji Konishi 《Skeletal radiology》1997,26(9):525-528
Objective. To clarify the MRI features of parasymphyseal insufficiency fractures of the os pubis. Design and patients. MRI was performed in four postmenopausal women with parasymphyseal insufficiency fractures. The diagnosis was confirmed with
plain films in every patient. T1-weighted and T2-weighted images were obtained in four patients using a 1.5-T unit. Postcontrast
T1-weighted imaging was also done in three patients. Results and conclusions. MRI of pubic parasymphyseal insufficiency fracture characteristically demonstrates a hyperintense mass lesion with a hypointense
rim on T2-weighted imaging, showing peripheral and septal enhancement after contrast administration. It is important to have
this entity in mind in patients with osteoporosis, especially in patients with a history of pelvic irradiation for malignant
disease, so as not to misinterpret it as a chondroid tumor or bone metastasis. 相似文献