Three-dimensional Pouchography: A Proof-of-concept Study of a Breakthrough Technique for Visualising Ileoanal Pouch Anatomy and Morphology in Normal and Mechanical Pouch Complication Patients.

Autor:	Holubar SD; Department of Colon & Rectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA., Nachand D; Department of Abdominal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA., Lavryk O; Department of Colon & Rectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA., Belkovsky M; Department of Colon & Rectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA., Brienza R; Department of Colon & Rectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA., Mohammed N; Department of Biomedical Engineering, Learner Research Institute, Cleveland Clinic, Cleveland, OH, USA., Ream J; Department of Abdominal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA., Hull T; Department of Colon & Rectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA., Steele SR; Department of Colon & Rectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA., Regueiro M; Department of Gastroenterology, Hepatology & Nutrition, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA., Cohen BL; Department of Gastroenterology, Hepatology & Nutrition, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA., Qazi T; Department of Gastroenterology, Hepatology & Nutrition, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA., Rieder F; Department of Gastroenterology, Hepatology & Nutrition, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA.
Jazyk:	angličtina
Zdroj:	Journal of Crohn's & colitis [J Crohns Colitis] 2024 Sep 03; Vol. 18 (9), pp. 1514-1519.
DOI:	10.1093/ecco-jcc/jjae058
Abstrakt:	Background: Herein, we present a proof-of-concept study of three-dimensional [3D] pouchography using virtual and printed 3D models of ileal pouch-anal anastomosis [IPAA] in patients with normal pouches and in cases of mechanical pouch complications. Methods: We performed a retrospective, descriptive case series of a convenience sample of 10 pouch patients with or without pouch dysfunction, who had CT scans appropriate for segmentation who were identified from our pouch registry. The steps involved in clinician-driven automated 3D reconstruction are presented. Results: We included three normal patients who underwent CT imaging and were found to have no primary pouch pathology, and seven patients with known pouch pathology identifiable with 3D reconstruction [including pouch strictures, megapouch, pouch volvulus, and twisted pouches], underwent 3D virtual modelling; one normal and one twisted pouch were 3D-printed. We discovered that 3D pouchography reliably identified staple lines [pouch body, anorectal circular and transverse, and tip of J], the relationship between staple lines, and variations in pouch morphology and pouch pathology. Conclusion: Three-dimensional reconstruction of IPAA morphology is highly feasible using readily available technology. In our practice, we have found 3D pouchography to be an extremely useful adjunct to diagnose various mechanical pouch complications and improve planning for pouch salvage strategies. Given its ease of use and helpfulness in understanding the pouch structure and function, we have started to routinely integrate 3D pouchography into our clinical pouch referral practice. Further study is needed to formally assess the value of this technique to aid in the diagnosis of pouch pathology. (© The Author(s) 2024. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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