Small Bowel MRI in Adult Patients: Not Just Crohn's Disease-a Tutorial

Overview

Journal Insights Imaging

Publisher Springer

Specialty Radiology

Date 2012 Oct 27

PMID 23100018

Citations 6

Authors

Giedre Kavaliauskiene

Manon L W Ziech

C Yung Nio

Jaap Stoker

Affiliations

Soon will be listed here.

Abstract

Objectives: To provide an overview of less well-known small bowel and mesenteric diseases found at small bowel magnetic resonance (MR) enterography/enteroclysis and to review the imaging findings. MR enterography and enteroclysis are important techniques for evaluation of small bowel diseases. In most centres these techniques are primarily used in Crohn's disease, and most radiologists are familiar with these MRI findings. However, the knowledge of findings in other diseases is often sparse, including diseases that may cause similar clinical symptoms to those of Crohn's disease.

Methods: We present a spectrum of less common and less well-known bowel and mesenteric diseases (e.g. internal hernia, intussusception, neuroendocrine tumour) from our small bowel MR database of over 2,000 cases.

Results: These diseases can be found in patients referred for bowel obstruction, abdominal pain or rectal blood loss. Further, in patients with (or suspected to have) Crohn's disease, some of these diseases (e.g. neuroendocrine tumour, familial Mediterranean fever) may mislead radiologists to erroneously diagnose active Crohn's disease.

Conclusion: Radiologists should be familiar with diseases affecting the small bowel other than Crohn's disease, including diseases that may mimic Crohn's disease.

Citing Articles

Small Bowel Imaging from Stepchild of Roentgenology to MR Enterography: Part I: Guidance in Performing and Observing Normal and Abnormal Imaging Findings.

Pierro A, Minordi L, Larosa L, Guerri G, Grimaldi A, Quinto F Life (Basel). 2023; 13(8).

PMID: 37629548 PMC: 10455392. DOI: 10.3390/life13081691.

Mimicking conditions of intestinal Crohn's disease: magnetic resonance enterography findings.

Cicero G, Blandino A, DAngelo T, Booz C, Vogl T, Ascenti G Jpn J Radiol. 2021; 40(1):19-28.

PMID: 34304381 DOI: 10.1007/s11604-021-01177-7.

Findings beyond Crohn's disease encountered on magnetic resonance enterography: a pictorial review of diseases inside and outside the bowel.

Yeap P, Szewczyk-Bieda M, Zealley I Singapore Med J. 2021; 62(4):173-181.

PMID: 33948670 PMC: 8801825. DOI: 10.11622/smedj.2021038.

Shortened oral contrast preparation for improved small bowel distension at MR enterography.

Bekendam M, Puylaert C, Phoa S, Nio C, Stoker J Abdom Radiol (NY). 2017; 42(9):2225-2232.

PMID: 28393302 PMC: 5556127. DOI: 10.1007/s00261-017-1133-4.

Intestinal tuberculosis versus crohn's disease: Clinical and radiological recommendations.

Sharma R, Madhusudhan K, Ahuja V Indian J Radiol Imaging. 2016; 26(2):161-72.

PMID: 27413261 PMC: 4931773. DOI: 10.4103/0971-3026.184417.

References

Ghai S, Pattison J, Ghai S, OMalley M, Khalili K, Stephens M . Primary gastrointestinal lymphoma: spectrum of imaging findings with pathologic correlation. Radiographics. 2007; 27(5):1371-88. DOI: 10.1148/rg.275065151. View

Berrocal T, Lamas M, Gutieerrez J, Torres I, Prieto C, del Hoyo M . Congenital anomalies of the small intestine, colon, and rectum. Radiographics. 1999; 19(5):1219-36. DOI: 10.1148/radiographics.19.5.g99se041219. View

Zissin R, Rathaus V, Gayer G, Shapiro-Feinberg M, Hertz M . CT findings in patients with familial Mediterranean fever during an acute abdominal attack. Br J Radiol. 2003; 76(901):22-5. DOI: 10.1259/bjr/32051823. View

Gupta A, Postgate A, Burling D, Ilangovan R, Marshall M, Phillips R . A prospective study of MR enterography versus capsule endoscopy for the surveillance of adult patients with Peutz-Jeghers syndrome. AJR Am J Roentgenol. 2010; 195(1):108-16. DOI: 10.2214/AJR.09.3174. View

Zissin R, Hertz M, Gayer G, Paran H, Osadchy A . Congenital internal hernia as a cause of small bowel obstruction: CT findings in 11 adult patients. Br J Radiol. 2005; 78(933):796-802. DOI: 10.1259/bjr/87050272. View

Lee N, Kim S, Jeon T, Kim H, Kim D, Seo H . Complications of congenital and developmental abnormalities of the gastrointestinal tract in adolescents and adults: evaluation with multimodality imaging. Radiographics. 2010; 30(6):1489-507. DOI: 10.1148/rg.306105504. View

Kanazawa T, Kasugai K, Miyata M, Miyashita M, Mizuno M, Nagase F . Midgut malrotation in adulthood. Intern Med. 2000; 39(8):626-31. View

Masselli G, Polettini E, Casciani E, Bertini L, Vecchioli A, Gualdi G . Small-bowel neoplasms: prospective evaluation of MR enteroclysis. Radiology. 2009; 251(3):743-50. DOI: 10.1148/radiol.2513081819. View

Takeyama N, Gokan T, Ohgiya Y, Satoh S, Hashizume T, Hataya K . CT of internal hernias. Radiographics. 2005; 25(4):997-1015. DOI: 10.1148/rg.254045035. View

10.

Malik A, Wani K, Khaja A . Meckel's diverticulum-Revisited. Saudi J Gastroenterol. 2010; 16(1):3-7. PMC: 3023098. DOI: 10.4103/1319-3767.58760. View

11.

Ben-Chetrit E, Touitou I . Familial mediterranean Fever in the world. Arthritis Rheum. 2009; 61(10):1447-53. DOI: 10.1002/art.24458. View

12.

Gore R, Mehta U, Berlin J, Rao V, Newmark G . Diagnosis and staging of small bowel tumours. Cancer Imaging. 2007; 6:209-12. PMC: 1766561. DOI: 10.1102/1470-7330.2006.0031. View

13.

Horton K, Kamel I, Hofmann L, Fishman E . Carcinoid tumors of the small bowel: a multitechnique imaging approach. AJR Am J Roentgenol. 2004; 182(3):559-67. DOI: 10.2214/ajr.182.3.1820559. View

14.

Cronin C, Lohan D, Browne A, Alhajeri A, Roche C, Murphy J . MR enterography in the evaluation of small bowel dilation. Clin Radiol. 2009; 64(10):1026-34. DOI: 10.1016/j.crad.2009.05.007. View

15.

Rufener S, Koujok K, McKenna B, Walsh M . Small bowel intussusception secondary to Peutz-Jeghers polyp. Radiographics. 2008; 28(1):284-8. DOI: 10.1148/rg.281075092. View

16.

Lohan D, Alhajeri A, Cronin C, Roche C, Murphy J . MR enterography of small-bowel lymphoma: potential for suggestion of histologic subtype and the presence of underlying celiac disease. AJR Am J Roentgenol. 2008; 190(2):287-93. DOI: 10.2214/AJR.07.2721. View

17.

Buckley J, Fishman E . CT evaluation of small bowel neoplasms: spectrum of disease. Radiographics. 1998; 18(2):379-92. DOI: 10.1148/radiographics.18.2.9536485. View

18.

Kim Y, Blake M, Harisinghani M, Archer-Arroyo K, Hahn P, Pitman M . Adult intestinal intussusception: CT appearances and identification of a causative lead point. Radiographics. 2006; 26(3):733-44. DOI: 10.1148/rg.263055100. View

19.

Stamatakos M, Douzinas E, Stefanaki C, Safioleas P, Polyzou E, Levidou G . Gastrointestinal stromal tumor. World J Surg Oncol. 2009; 7:61. PMC: 2749031. DOI: 10.1186/1477-7819-7-61. View

20.

Levy A, Sobin L . From the archives of the AFIP: Gastrointestinal carcinoids: imaging features with clinicopathologic comparison. Radiographics. 2007; 27(1):237-57. DOI: 10.1148/rg.271065169. View