Aims and objectives
Magnetic resonance enterography (MRE) provides information in the study of Crohn's disease (CD) and requires gadolinium injection.
Through the MR images it is possible to identify the main features of the disease such as the involvement of the bowel wall,
and the involvement of the near structures,
especially the mesentery [1-7].
In particular,
MRE allows the hypertense signal of mesentery in the case of inflammation or hypointense in the case of fibrosis.
Even the elastography (USE) maybe can distinguish the change of fibrotic and edematous...
Methods and materials
Twenty-one patients (12 male and 9 female) with mean age of 31,22 ± 8,44 with Crohn disease underwent magnetic resonance enterography and in the same time a real-time USE from July 2014 to August 2015,
in our Department.
All patients have a histological diagnosis of Crohn disease.
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The MR studies had been performed on two 1.5 Tesla superconducting device (Philips Medical Systems,
Shelton,
CT).
Patients fasted for 6 h before the MRI examination.
MR studies were realized...
Results
In our experience there was a significant (p<0,05) restriction of the diffusion in 13 patients with CD in the active phase,
in particular the mean ADC values for the fibrotic mesentery 2,80 ± 0,33 x 10-3,
while the mean ADC values for oedematous mesentery: 2,20 ± 0,41 x 10-3.
In the study group,
the USE colour-scale coding showed a colour change from blue to red in the fibrotic change of mesentery (see Figure 2-3),
and blue-green in the oedematous change (see Figure 3),
8 and...
Conclusion
Our results indicate that fibrotic and oedematous change of mesentery of patients with CD cause restricted diffusion and that DWI yields both qualitative (increased signal intensity) and quantitative (decreased ADC values) information that can be helpful in the evaluation of mesentery.
USE also confirmed the nonsolid nature of the mesenteric mass because the tumor appeared almost entirely green (soft) on hardness colorimetric scale.
Evaluation of CD through USE and DWI is a more and more growing field,
and many tools are available.
References
1)Prassopoulos P,
Papanikolaou N,
Grammatikakis J,
Rousomoustakaki M,
Maris T,
Gourtsoyiannis N.
MR enteroclysis imaging of Crohn disease.
Radiographics 2001;21:S161-72
2)Rieber A,
Aschoff A,
Nussle K,
Wruk D,
Tomczak R,
Reinshagen M,
et al.
MRI in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis.
Eur Radiol 2000;10(9):1377-82
4)David G.
Binion,
MD.
Biologic Therapies for Crohn's Disease.
Gastroenterol Hepatol (N Y).
Jan 2010; 6(1 Suppl 2): 4-16
5)S.Colagrande,S.Pallotta,A.Vanzulli,M.Napolitano,N.Villari - Il parametro «Diffusione» in Risonanza Magnetica: elementi...
