CT and MRI Evaluations in Crohn's Complications: A Guide for the Radiologist

Minordi, Laura Maria; Bevere, Antonio; Papa, Alfredo; Larosa, Luigi; Manfredi, Riccardo

doi:10.1016/j.acra.2021.07.025

Cited by 28 publications

(19 citation statements)

References 60 publications

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“…This group of patients was the most frequently encountered clinically. In the future, we can improve the measurement of endoscopic activity to study global MRE index assessments (35). Finally, we could not be sure that our endoscopic site exactly matched the site for which the imaging score was obtained.…”

Section: Discussionmentioning

confidence: 99%

A magnetic resonance enterography index for assessing small bowel Crohn’s disease activity

Zuo¹,

Huang²,

Wei³

et al. 2023

Quant Imaging Med Surg

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Background: This study aimed to construct a magnetic resonance imaging (MRI) index for assessing transmural inflammatory activity in the small intestine of patients with Crohn' disease which enables rapid and non-invasive quantitative assessment of Crohn's disease inflammation. Methods:In this prospective study, magnetic resonance enterography (MRE) was performed to examine 29 consecutive patients with Crohn's disease who had undergone ileocolonoscopy in the Jingling hospital of Nanjing. This diagnostic study was not registered on a clinical trial platform. We grade the T2 signal ratio and T1 enhancement ratio with a score of 0 to 3. The ratios were calculated as follow: terminal ileal inflammation of intestinal T2 signal intensity/adjacent normal intestinal T2 signal intensity (T2 ratio 1), terminal ileal inflammation intestinal T2 signal intensity/vertical muscle T2 signal intensity (T2 ratio 2), the fifth phase of the inflamed intestinal T1 signal intensity/noncontrast intestine T1 signal (T1 ratio 3), and the fifth phase of inflamed intestinal T1 signal intensity/adjacent normal intestinal T1 signal (T1 ratio 4). Wall thickness, lymph nodes, perimural T2 signal, comb sign, and ulceration were graded from 0 to 3. the simple endoscopic score for Crohn's disease (SES-CD) from 0 to 12 was used to assess Crohn's disease activity as a reference. The study calculated the correlations between the MRE activity index and endoscopic activity scores and derived the MRE index model to assess Crohn's disease activity. Results:The MRE index model (a T1 ratio 4 score of 1.52 + an ulceration score of 2.03) had a sensitivity of 0.962, a specificity of 0.667, and an area under the curve (AUC) of 0.968 [95% confidence interval (CI): 0.921-1.000]. The intraclass correlation coefficient (ICC) for the interobserver agreement of the MRE index was 0.921 (95% CI: 0.833-0.963). Conclusions:The study derived an MRE index with good sensitivity to inflammatory changes in the small bowel. The index could be used to assess Crohn's disease activity of the small bowel.

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Section: Discussionmentioning

confidence: 99%

A magnetic resonance enterography index for assessing small bowel Crohn’s disease activity

Zuo¹,

Huang²,

Wei³

et al. 2023

Quant Imaging Med Surg

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show abstract

“…The sensitivity and specificity for the predictions by two radiologists were 92.3, 59% and 100, 52.3%, respectively. Minordi et al ( 10 ) further uncovered that MRE provides a superior soft-tissue contrast resolution and a better visualization of the intestinal wall and its inflammatory and fibrotic characteristics. In addition, computed tomography enterography (CTE) is another well-established diagnostic technique for evaluating the intestinal cavity’s patency.…”

Section: Discussionmentioning

confidence: 99%

Crohn’s Disease Complicated by Rare Types of Intestinal Obstruction: Two Case Reports

Xia

Gao

et al. 2022

Front. Med.

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Intestinal obstruction is one of the most common complications of Crohn’s disease (CD), jeopardizing the quality of life of patients. Numerous factors may contribute to intestinal obstruction in CD. Thus far, the primary reason has been identified as intestinal fibrosis caused by repeated chronic inflammation during the active phase of CD. Herein, we report two rare complicated CD cases and provide a reference for the clinical diagnosis and treatment of similar patients. Case one involves capsule endoscope retention in the small intestine of one CD patient concurrent with intestinal obstruction. Case two is a CD patient with intestinal obstruction caused by a mesangial hernia and ileal stenosis. Individualized and minimally invasive surgical intervention ultimately resulted in the successful management of these two patients. The two cases serve as an excellent guide for diagnosing and treating CD patients who present with similar symptoms.

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“…CD usually occurs in all layers of the intestinal wall and in any part of the intestinal mucosa [ 3 ]. People with IBD often have symptoms such as rectal bleeding, diarrhea, abdominal pain, and weight loss [ 4 ]. So far, there is no definite cause of IBD.…”

Section: Introductionmentioning

confidence: 99%

The Potential Role of Vitamin E and the Mechanism in the Prevention and Treatment of Inflammatory Bowel Disease

Wu,

Luo,

et al. 2024

Foods

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Inflammatory bowel disease (IBD) includes ulcerative colitis and Crohn’s disease, and it is a multifactorial disease of the intestinal mucosa. Oxidative stress damage and inflammation are major risk factors for IBD. Vitamin E has powerful antioxidant and anti-inflammatory effects. Our previous work and other investigations have shown that vitamin E has a positive effect on the prevention and treatment of IBD. In this paper, the source and structure of vitamin E and the potential mechanism of vitamin E’s role in IBD were summarized, and we also analyzed the status of vitamin E deficiency in patients with IBD and the effect of vitamin E supplementation on IBD. The potential mechanisms by which vitamin E plays a role in the prevention and treatment of IBD include improvement of oxidative damage, enhancement of immunity, maintenance of intestinal barrier integrity, and suppression of inflammatory cytokines, modulating the gut microbiota and other relevant factors. The review will improve our understanding of the complex mechanism by which vitamin E inhibits IBD, and it also provides references for doctors in clinical practice and researchers in this field.

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CT and MRI Evaluations in Crohn's Complications: A Guide for the Radiologist

Cited by 28 publications

References 60 publications

A magnetic resonance enterography index for assessing small bowel Crohn’s disease activity

A magnetic resonance enterography index for assessing small bowel Crohn’s disease activity

Crohn’s Disease Complicated by Rare Types of Intestinal Obstruction: Two Case Reports

The Potential Role of Vitamin E and the Mechanism in the Prevention and Treatment of Inflammatory Bowel Disease

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