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Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
MR enterography imaging of Crohn's disease in pediatric patients
Joanna Podgórska1, Ryszard Pacho1, Piotr Albrecht2
12 Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
Insights
MR enterography is a valuable tool for diagnosing pediatric Crohn disease (CD), offering accurate insights into disease severity and complications without radiation exposure.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Radiology
Background:
- Crohn disease (CD) is a chronic gastrointestinal inflammatory condition affecting children.
- Advances in Magnetic Resonance Imaging (MRI) enable effective small bowel imaging in pediatric patients.
- MR enterography (MRE) is crucial for diagnosing and managing pediatric CD.
Purpose of the Study:
- To describe characteristic MR enterography findings in pediatric Crohn disease.
- To highlight the advantages of MRE in pediatric patients.
- To evaluate MRE's utility in assessing disease severity and complications.
Main Methods:
- 40 pediatric patients (7-18 years) with suspected or diagnosed CD underwent MRE.
- Small bowel distention achieved with polyethylene glycol (PEG) solution.
- Spasmolytic agent (hyoscine-N-butylbromide) administered to reduce peristalsis.
Main Results:
- Abnormalities detected in 21 patients with small bowel involvement, 5 with colonic disease, and 2 with both.
- Common findings included bowel wall thickening (n=21), hyperenhancement (n=18), and lymphadenopathy (n=28).
- Other observed signs: submucosal edema, ulceration, fistula, stenosis, hyperemia, and fibrofatty proliferation.
Conclusions:
- MR enterography provides accurate information on CD severity, activity, and complications in children.
- MRE is particularly advantageous in pediatric care due to the absence of ionizing radiation.
- This modality is essential for effective diagnosis and management of pediatric Crohn disease.
Background:
Crohn disease (CD) is a chronic inflammatory process of gastrointestinal tract, which frequently affects children. Recent advances in Magnetic Resonance Imaging (MRI) technique have made small bowel imaging possible, what is extremely useful in pediatrics. The purpose of this article is to describe the characteristic MR enterography findings and to present the advantages of this modality in pediatric patients.
Material/Methods:
A group of 40 patients referred from the Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw was included in the analysis. The patients' age ranged from 7 to 18 years (mean age 14 years). Among the study participants, 28 patients were diagnosed with CD, whereas 12 patients had a history of ulcerative colitis or were strongly suspected of CD based on clinical data. The examinations were performed on GE Signa HD 1,5 T system. Small bowel distention was achieved by oral administration of 600-1000 ml of hyperosmotic solution of polyetylenglycol (PEG). Prior to the examination, 20-40 mg of a spasmolytic drug, hioscine-N-butylobromide (Buscolysin(®)), was administrated to reduce peristaltic movements.
Results:
The abnormal small bowel segments were found in 21 patients and the features of colonic disease were detected in 5 patients. In 2 patients the lesions involved both small and large bowel. In 16 subjects mural changes were not found. Among studied patients, following signs of small bowel inflammation were fund: bowel wall thickening (n=21), submucosal edema (n=8), segment wall hyperenhancement (n=18), deep ulceration (n=6), fistula (n=3), stenosis (n=7), mesenteric signs such as hyperemia (n=9), fibrofatty proliferation (n=8) and lymphadenopathy (n=28).
Conclusions:
MR enterography is an excellent examination, which provides an accurate information about severity and activity of and complications related to CD. It is especially valuable in children, because of lack of the negative consequences of repeated exposure to ionizing radiation.
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