Magnetic resonance imaging in children and adolescents with chronic inflammatory bowel disease
| Autor: | Steffen Reinsch, Monika Kurzai, M Stenzel, Hans-Joachim Mentzel |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Adolescent Contrast Media Inflammatory bowel disease Severity of Illness Index Diagnosis Differential Crohn Disease Predictive Value of Tests Risk Factors medicine Humans Topic Highlight Child Crohn's disease medicine.diagnostic_test business.industry Ultrasound Gastroenterology Age Factors Magnetic resonance imaging General Medicine medicine.disease Prognosis Ulcerative colitis Magnetic Resonance Imaging Surgery Intestines Contrast medium Colitis Ulcerative Differential diagnosis business Diffusion MRI |
| Zdroj: | World journal of gastroenterology. 20(5) |
| ISSN: | 2219-2840 |
| Popis: | Inflammatory bowel diseases (IBD) represent challenges, both from a diagnostic, and therapeutic point of view. Deep-seated anatomic structures are difficult to assess by ultrasound technique alone. As radiation-free alternative cross-sectional imaging method, magnetic resonance imaging of the intestinal structures is costly and time-consuming. Examination of pediatric patients imply additional considerations: reduction of body motions in younger children and consideration of the most appropriate preparation, and examination technique. The demanding Sellink technique is the only means for appropriately distending the lesser intestine in order to detect small bowel strictures. Oral intake of contrast medium (CM) alone shows its limitations regarding distensibility. The need for intravenous contrast media application needs to be considered, too. Active inflammation of both intestinal wall, and mesentery can be demonstrated accurately. Nevertheless, viable alternatives to CM application is desirable, considering non-negligible adverse reactions. Recent data suggest diffusion weighted imaging might fill this diagnostic gap. Irrespective of sequence technique chosen, bowel movement remains a major obstacle. Antispasmolytics in their function as smooth muscle relaxants help in improving image quality, however, their use in children might be off-label. Optimal preparation for the examination and appropriate imaging technique allow for diagnosing typical patterns of changes in IBD, such as bowel wall thickening, ulcers, mural stratification, strictures, creeping fat, and comb sign, and lymphadenopathy. The article gives a detailed overview of current significance of magnetic resonance imaging pediatric patients suffering from IBD, considering indications, limitations, and safety aspects. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|