Inflammatory bowel disease: value in diagnosis and management of MDCT-enteroclysis and 99mTc-HMPAO labeled leukocyte scintigraphy

Grassi, Roberto; Rambaldi, Pier Francesco; Grezia, Graziella Di; Mansi, Luigi; Cuccurullo, Vincenzo; Cirillo, A.; Riegler, G.; Cappabianca, Salvatore; Rotondò, Antonio

doi:10.1007/s00261-010-9652-2

Cited by 16 publications

(11 citation statements)

References 19 publications

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“…injection of 120–140 mL of a contrast agent (Ultravist 370, Schering AG, Berlin, Germany): 40–50 mL at a rate of 1 mL/s followed by a bolus of 80–90 mL at a rate of 3 mL/s. Due to the unavailability of a validated score to quantify transmural activity at CTE, an expert radiologist, blind to endoscopic and clinical activity, reviewed all CTE images and expressed a qualitative judgement on transmural disease activity, based on typical CD lesions on CTE (Table 2) [14-16] and stratified on 3 grades: remission, mild-to-moderate and moderate-to-severe (Table 1). …”

Section: Methodsmentioning

confidence: 99%

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Laterza

Piscaglia

Minordi

et al. 2018

Dig Dis

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Aim: To evaluate if a single and/or combined (clinical, endoscopic and radiological) assessment could predict clinical outcomes in Crohn’s disease (CD). Methods: We prospectively evaluated 57 CD cases who underwent both a colonoscopy and a CT-enterography (CTE). Harvey-Bradshaw Index (HBi), SES-CD (and/or Rutgeerts score) and the radiological disease activity were defined to stratify patients according to clinical, endoscopic and radiological disease activity respectively. Hospitalizations, surgery, therapeutic changes and deaths were evaluated up to 36 months (time 1) for 53 patients. Results: CTE and endoscopy agreed in stratifying disease activity in 47% of cases (k = –0.05; p = 0.694), CTE and HBi in 35% (k = 0.09; p = 0.08), endoscopy and HBi in 39% (k = 0.13; p = 0.03). Taken together, CTE, endoscopy and HBi agreed only in 18% of cases (k = 0.01; p = 0.41). Among the 11 cases with mucosal healing, only 3 (27%) showed transmural healing. Patients with endoscopic activity needed significantly more changes of therapy compared to patients with endoscopic remission (p = 0.02). Patients with higher transmural or clinical activity at baseline required significantly more hospitalizations (p < 0.01). Hospitalization rate decreases with an increase in the number of parameters indicating remissions at baseline (p = 0.04). Conclusions: Clinical, endoscopic and radiological assessments offer complementary information and could predict different mid-term outcomes in CD.

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Section: Methodsmentioning

confidence: 99%

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Laterza

Piscaglia

Minordi

et al. 2018

Dig Dis

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“…If perforation is suspected, patients are usually subjected to abdominal MSCT, especially because ultrasonography is operator-dependent, some patients are less cooperative, the exam is diffucult in obese patients and in those with subcutaneous emphysema; otherwise MSCT, expecially after six hours after symptoms begin, is useful to assess gastrointestinal perforation as it allows detection of even small amounts of free air in the abdomen [32] . …”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal perforation: ultrasonographic diagnosis

et al. 2013

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Gastrointestinal tract perforations can occur for various causes such as peptic ulcer, inflammatory disease, blunt or penetrating trauma, iatrogenic factors, foreign body or a neoplasm that require an early recognition and, often, a surgical treatment.Ultrasonography could be useful as an initial diagnostic test to determine, in various cases the presence and, sometimes, the cause of the pneumoperitoneum.The main sonographic sign of perforation is free intraperitoneal air, resulting in an increased echogenicity of a peritoneal stripe associated with multiple reflection artifacts and characteristic comet-tail appearance.It is best detected using linear probes in the right upper quadrant between the anterior abdominal wall, in the prehepatic space.Direct sign of perforation may be detectable, particularly if they are associated with other sonographic abnormalities, called indirect signs, like thickened bowel loop and air bubbles in ascitic fluid or in a localized fluid collection, bowel or gallbladder thickened wall associated with decreased bowel motility or ileus.Neverthless, this exam has its own pitfalls. It is strongly operator-dependant; some machines have low-quality images that may not able to detect intraperitoneal free air; furthermore, some patients may be less cooperative to allow for scanning of different regions; sonography is also difficult in obese patients and with those having subcutaneous emphysema. Although CT has more accuracy in the detection of the site of perforation, ultrasound may be particularly useful also in patient groups where radiation burden should be limited notably children and pregnant women.

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“…We focused on nuclear medicine studies of interest in an emergency care setting and did not discuss nuclear medicine techniques which could be of interest in urgent care [53].…”

Section: Discussionmentioning

confidence: 99%

Nuclear medicine and the emergency department patient: an illustrative case-based approach

et al. 2014

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Radiologists are familiar with the use of radiographs, computed tomography, magnetic resonance imaging and ultrasound in the acute clinical setting. However, there are some specific clinical scenarios which may be found in nuclear medicine imaging problem-solving tools. These clinical scenarios and imaging techniques are less frequent, and the referring clinician from the emergency department may not consider these alternatives. It is important for the radiologist to be aware of these techniques to be able to guide the clinician to use those tools, which may result in optimal patient care. In this article, we will discuss those nuclear medicine studies which have application in the setting of an emergency radiology practice.

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Inflammatory bowel disease: value in diagnosis and management of MDCT-enteroclysis and 99mTc-HMPAO labeled leukocyte scintigraphy

Cited by 16 publications

References 19 publications

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Gastrointestinal perforation: ultrasonographic diagnosis

Nuclear medicine and the emergency department patient: an illustrative case-based approach

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