1
|
Heidarzadeh Arani M, Razavizadeh M, ArefNezhad R, Motedayyen H. Selective immunoglobulin M deficiency in a patient with celiac disease and recurrent pneumonia. Clin Case Rep 2021; 9:158-163. [PMID: 33505686 PMCID: PMC7813123 DOI: 10.1002/ccr3.3489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 11/30/2022] Open
Abstract
SIgMD is a rare immune disorder that occurs in a primary or secondary condition. Patients with recurrent infectious, cancers, and autoimmune disorders should be investigated to determine SIgMD.
Collapse
Affiliation(s)
| | - Mohsen Razavizadeh
- Research Center for Biochemistry and Nutrition in Metabolic DiseasesKashan University of Medical SciencesKashanIran
- Autoimmune Diseases Research CenterKashan University of Medical SciencesKashanIran
| | - Reza ArefNezhad
- Exir Azma Salam Iranian instituteResearch and Development DepartmentTehranIran
- Department of AnatomySchool of MedicineShiraz University of Medical SciencesShirazIran
| | - Hossein Motedayyen
- Autoimmune Diseases Research CenterKashan University of Medical SciencesKashanIran
| |
Collapse
|
2
|
Barat M, Dohan A, Dautry R, Barral M, Boudiaf M, Hoeffel C, Soyer P. Mass-forming lesions of the duodenum: A pictorial review. Diagn Interv Imaging 2017; 98:663-675. [PMID: 28185840 DOI: 10.1016/j.diii.2017.01.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 01/04/2017] [Accepted: 01/05/2017] [Indexed: 02/07/2023]
Abstract
Recent advances in imaging have resulted in marked changes in the investigation of the duodenum, which still remains primarily evaluated with videoendoscopy. However, improvements in computed tomography (CT) and magnetic resonance (MR) imaging have made detection and characterization of duodenal mass-forming abnormalities easier. The goal of this pictorial review was to illustrate the most common conditions of the duodenum that present as mass-forming lesions with a specific emphasis on CT and MR imaging. MR imaging used in conjunction with duodenal distension appears as a second line imaging modality for the characterization of duodenal mass-forming lesions. CT remains the first line imaging modality for the detection and characterization of a wide range of duodenal mass-forming lesions.
Collapse
Affiliation(s)
- M Barat
- Department of Radiology, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - A Dohan
- Department of Radiology, McGill University Health Centre, Montreal General and Royal Victoria Hospitals, Montreal, Canada.
| | - R Dautry
- Department of Radiology, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - M Barral
- Department of Radiology, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - M Boudiaf
- Pôle santé du plateau, 3/5, avenue de Villacoublay, 92360 Meudon-La-Forêt, France.
| | - C Hoeffel
- Department of Radiology, hôpital Robert-Debré, 11, boulevard Pasteur, 51092 Reims, France.
| | - P Soyer
- Medicine department, Université Paris-Diderot, Sorbonne Paris Cité, 10, avenue de Verdun, 75010 Paris, France.
| |
Collapse
|
3
|
Nay J, Menias CO, Mellnick VM, Balfe DM. Gastrointestinal manifestations of systemic disease: a multimodality review. ACTA ACUST UNITED AC 2016; 40:1926-43. [PMID: 25548008 DOI: 10.1007/s00261-014-0334-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Systemic diseases have many different presentations, including imaging findings in the bowel. Recognizing the imaging findings in these diseases is important in making the correct diagnosis. Although certain imaging features overlap, knowledge of specific findings along with the clinical presentation aid in narrowing the differential or in making an imaging diagnosis. The pictorial review will focus on the gastrointestinal manifestations of systemic diseases, including amyloidosis, angiotensin converter enzyme inhibitor-induced angioedema, celiac sprue, distal intestinal obstruction syndrome, graft-versus-host disease, hemolytic uremic syndrome, hemophilia, Henoch-Schönlein purpura, intestinal lymphangiectasia, mastocytosis, scleroderma, systemic lupus erythematosus, Wegener's granulomatosis, and Whipple's disease. The aforementioned diseases can be subdivided based upon the underlying process leading to the disease. The diseases discussed are categorized into autoimmune, infiltrative, treatment related, congenital/hereditary, and infectious etiologies.
Collapse
Affiliation(s)
- John Nay
- Washington University School of Medicine Mallinckrodt Institute of Radiology, 510 S. Kingshighway Blvd, Saint Louis, MO, 63110, USA,
| | | | | | | |
Collapse
|
4
|
El-Kalioubie M, Ali R. Abdominal CT enterography as an imaging tool for chronic diarrhea: Review of technique and diagnostic criteria. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2015.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
|
5
|
|
6
|
van der Merwe B, Ackermann C, Els H. CT enteroclysis in the developing world: How we do it, and the pathology we see. Eur J Radiol 2013; 82:e317-25. [DOI: 10.1016/j.ejrad.2013.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 03/21/2013] [Accepted: 03/27/2013] [Indexed: 12/20/2022]
|
7
|
Smereczyński A, Starzyńska T, Kołaczyk K. Ultrasound of selected pathologies of the small intestine. J Ultrason 2013; 13:155-66. [PMID: 26672622 PMCID: PMC4613592 DOI: 10.15557/jou.2013.0016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 12/20/2012] [Accepted: 01/21/2013] [Indexed: 01/14/2023] Open
Abstract
UNLABELLED Intestines, especially the small bowel, are rarely subject to US assessment due to the presence of gases and chyme. The aim of this paper was to analyze ultrasound images in selected pathologies of the small intestine in adults, including the aspects of differential diagnosis. MATERIAL AND METHODS In 2001-2012, abdominal ultrasound examinations were conducted in 176 patients with the following small bowel diseases: Crohn's disease (n=35), small bowel obstruction (n=35), yersiniosis (n=28), infectious diarrhea (n=26), bacterial overgrowth syndrome (n=25), coeliac disease (n=15) and small bowel ischemia (n=12). During examinations patients were fasting and no other particular preparations were needed. Convex transducers of 3.5-6 MHz and linear ones of 7-12 MHz were used. The assessment of the small intestine in four abdominal quadrants constituted an integral element of the examination. The following features of the small bowel ultrasound presentation were subject to analysis: thickness and perfusion of the walls, presence of thickened folds in the jejunum, reduction of their number, presence of fluid and gas contents in the intestine, its peristaltic activity, jejunization of the ileum and enteroenteric intussusception. Furthermore, the size of the mesenteric lymph nodes and the width of the superior mesenteric artery were determined and the peritoneal cavity was evaluated in terms of the presence of free fluid. RESULTS Statistically significant differences were obtained between the thickness of the small intestine in Crohn's disease or in ischemic conditions and the thickness in the remaining analyzed pathological entities. Small bowel obstruction was manifested by the presence of distended loops due to gas and fluid as well as by severe peristaltic contractions occurring periodically. In the course of ischemic disease, the intestinal walls were thickened without the signs of increased perfusion and in the majority of cases intestinal stenosis was observed. Fluid in the intestine was detected in all patients with coeliac disease, gas in 86.7% of patients, thickening of the folds in the jejunum in 86.7%, their reduction in 80%, increased (enhanced) peristalsis in 93.3% and jejunization in 40%. In 80% of coeliac disease cases, the intestine showed the features of hyperemia on color Doppler examination and in 53.3% of patients the dilated lumen of the superior mesenteric artery was detected. Enlarged mesenteric lymph nodes were visualized in 73.3% of the subjects, enteroenteric intussusception in 33.3% and free fluid in the peritoneal cavity in 60%. CONCLUSIONS Small bowel obstruction is manifested by the presence of evidently dilated intestinal loops filled with gas and fluid and periodical severe deepened peristalsis.Ischemic changes and Crohn's disease are characterized by the presence of fragmentarily thickened intestinal walls and intestinal stenosis. Moreover, in Crohn's disease, increased wall perfusion and mesenteric adenomegaly is encountered.Coeliac disease is manifested by: increased amount of fluid mainly in the jejunum, thickened and hyperemic jejunal walls, increased peristalsis;hypertrophied mucosal folds - often their number is reduced, jejunization and transient enteroenteric intussusception;ultrasound changes that require the differentiation with small intestinal bacterial overgrowth syndrome and, to a lesser degree, with infectious diarrhea.
Collapse
Affiliation(s)
| | - Teresa Starzyńska
- Klinika Gastrologii, Pomorski Uniwersytet Medyczny, Szczecin, Polska
| | - Katarzyna Kołaczyk
- Zakład Diagnostyki Obrazowej i Radiologii Interwencyjnej, Pomorski Uniwersytet Medyczny, Szczecin, Polska
| |
Collapse
|
8
|
Andres O´Brien S. Evaluación imaginológica del intestino delgado por TC y RM. REVISTA MÉDICA CLÍNICA LAS CONDES 2013. [DOI: 10.1016/s0716-8640(13)70135-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
9
|
Paparo F, Garlaschi A, Biscaldi E, Bacigalupo L, Cevasco L, Rollandi GA. Computed tomography of the bowel: a prospective comparison study between four techniques. Eur J Radiol 2012; 82:e1-e10. [PMID: 22999647 DOI: 10.1016/j.ejrad.2012.08.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 07/28/2012] [Accepted: 08/26/2012] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The major objective was to prospectively compare the grade of bowel distension obtained with four different computed tomography (CT) techniques dedicated for the examination of the small intestine (CT enteroclysis [CTE] and enterography [CTe]), of the colon (CT with water enema [CT-WE]), or both (CTe with water enema [CTe-WE]). The secondary objective was to assess patients' tolerance toward each CT protocol. MATERIALS AND METHODS Recruitment was designed to obtain four groups of the same number of patients (30). Each group corresponded to a specific CT technique, for a total of 120 consecutive outpatients (65 male and 55 female, mean age 51.09 ± 13.36 years). CTE was performed after injection of methylcellulose through a nasojejunal tube, while in the CTe protocol a polyethylene glycol electrolyte solution was orally administered to patients prior to the CT acquisition. In the CT-WE protocol intraluminal contrast (water) was administered only by a rectal enema, while CTe-WE technique included both a rectal water enema and oral ingestion of neutral contrast material to obtain a simultaneous distension of small and large bowel. CT studies were reviewed in consensus by two gastrointestinal radiologists who performed a quantitative and qualitative analysis of bowel distension on a per segment basis. The presence and type of adverse effects were recorded. RESULTS CTE provided the best distension of jejunal loops (median diameter 27 mm, range 17-32 mm) when compared to all the other techniques (p<0.0001). The frequency of patients with an adequate distension of the terminal ileum was not significantly different among the four groups (p=0.0608). At both quantitative and qualitative analysis CT-WE and CTe-WE determined a greater and more consistent luminal filling of the large intestine than that provided by both CTE and CTe (p<0.0001 for all colonic segments). Adverse effects were more frequent in patients belonging to the CTE group (p<0.0028). CONCLUSIONS CTE allows an optimal distension of jejunal loops, but it is the most uncomfortable CT protocol. When performing CT-WE, an adequate retrograde distension of the terminal ileum was provided in a particularly high percentage of patients. CTe-WE provides a simultaneous optimal distension of both small and large bowel.
Collapse
Affiliation(s)
- Francesco Paparo
- Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy
| | | | | | | | | | | |
Collapse
|
10
|
Hristova L, Placé V, Nemeth J, Boudiaf M, Laurent V, Soyer P. Small bowel tumors: spectrum of findings on 64-section CT enteroclysis with pathologic correlation. Clin Imaging 2012; 36:104-12. [PMID: 22370131 DOI: 10.1016/j.clinimag.2011.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 08/12/2011] [Accepted: 08/12/2011] [Indexed: 12/19/2022]
Abstract
Improvements in helical technology have made detection of benign and malignant small bowel tumors easier so that they are now frequently detected at an early stage. Sixty-four-section CT enteroclysis provides suggestive features that help determine the actual nature of a small bowel tumor in a large number of cases. Specific diagnosis of small bowel tumor is based on a combination of findings that are depicted owing to the use of the multiple capabilities of 64-section CT enteroclysis, allowing optimal planning prior to endoscopic or surgical resection.
Collapse
Affiliation(s)
- Lora Hristova
- Department of Abdominal Imaging, Hôpital Lariboisière-AP-HP and Université, Diderot-Paris, France.
| | | | | | | | | | | |
Collapse
|
11
|
Abstract
Recently introduced endoscopy-based imaging methods such as double-balloon endoscopy or wireless capsule endoscopy can visualize the complete small bowel. These approaches are quite invasive diagnostic methods. Therefore, radiological small bowel imaging is also still considered as the primary imaging approach to diagnose pathological changes of the small bowel. In this review article the most important small bowel imaging modalities such as conventional fluoroscopy, computed tomography, magnetic resonance imaging and ultrasound are discussed. Additionally the most important diseases, which can affect the small bowel, are evaluated and the optimal imaging modalities are pointed out, respectively.
Collapse
Affiliation(s)
- A G Schreyer
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
| | | |
Collapse
|
12
|
|
13
|
Van Weyenberg SJB, Meijerink MR, Jacobs MAJM, van Kuijk C, Mulder CJ, van Waesberghe JHTM. MR enteroclysis in refractory celiac disease: proposal and validation of a severity scoring system. Radiology 2011; 259:151-61. [PMID: 21330559 DOI: 10.1148/radiol.11101808] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To determine magnetic resonance (MR) enteroclysis findings in patients with uncomplicated celiac disease (CD), refractory CD (RCD) type I, and RCD type II, to develop and validate a scoring system to identify patients with RCD II and to determine the diagnostic accuracy of MR enteroclysis to detect CD-related malignancies. MATERIALS AND METHODS This study was performed with approval of the institutional review board. One radiologist blinded to clinical details retrospectively evaluated quantitative and qualitative criteria of 28 studies obtained in symptomatic patients with CD (uncomplicated CD, n = 10; RCD I, n = 8; RCD II, n = 10). A scoring system was developed by using parameters identified in multivariate analysis to be associated with RCD II, which two radiologists evaluated in a second group of 40 symptomatic patients with CD. Accuracy to detect malignancy was assessed in the total study group. Cumulative survival was evaluated in the total study group by using the Kaplan-Meier method. RESULTS MR enteroclysis could not be used to discriminate between uncomplicated CD and RCD I. The presence of less than 10 folds per 5 cm jejunum, mesenteric fat infiltration, and bowel wall thickening were associated with RCD II. A positive MR score was defined as the presence of two or more of these features. In the validation group, the MR score was positive in 13 of 15 patients with RCD II (sensitivity, 0.87) and negative in 24 of 25 patients without RCD II (specificity, 0.96). The 5-year survival rate was 95% in patients with a negative MR score and 56% in patients with a positive MR score (P < .0001). MR enteroclysis helped to identify the presence of seven of eight malignancies and to diagnose absence of malignancy in 58 of 60 studies. CONCLUSION MR enteroclysis can be used to investigate the presence of RCD II or malignancy in symptomatic patients with CD.
Collapse
Affiliation(s)
- Stijn J B Van Weyenberg
- Department of Gastroenterology, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
| | | | | | | | | | | |
Collapse
|
14
|
Soyer P, Boudiaf M, Fishman EK, Hoeffel C, Dray X, Manfredi R, Marteau P. Imaging of malignant neoplasms of the mesenteric small bowel: new trends and perspectives. Crit Rev Oncol Hematol 2010; 80:10-30. [PMID: 21035353 DOI: 10.1016/j.critrevonc.2010.09.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 09/29/2010] [Accepted: 09/30/2010] [Indexed: 12/13/2022] Open
Abstract
This article describes the recent advances in radiological imaging of malignant neoplasms of the mesenteric small bowel and provides an outline of new trends and perspectives that can be anticipated. The introduction of multidetector row technology, which allows the acquisition of submillimeter and isotropic voxels, has dramatically improved the capabilities of computed tomography in the investigation of the mesenteric small bowel. This technology combined with optimal filling of small bowel loops through the use of appropriate enteral contrast agents has markedly changed small bowel imaging. Computed tomography-enteroclysis, which is based on direct infusion of enteral contrast agent into the mesenteric small bowel through a naso-jejunal tube, provides optimal luminal distension. By contrast, computed tomography-enterography is based on oral administration of enteral contrast agent. These two techniques are now well-established ones for the detection and the characterization of small bowel neoplasms. During the same time, combining the advantages of unsurpassed soft tissue contrast and lack of ionizing radiation, magnetic resonance imaging has gained wide acceptance for the evaluation of patients with suspected small bowel neoplasms. Rapid magnetic resonance imaging sequences used in combination with specific enteral contrast agents generate superb images of the mesenteric small bowel so that magnetic resonance-enteroclysis and magnetic resonance-enterography are now considered as effective diagnostic tools for both the detection and the characterization of neoplasms of the mesenteric small bowel. Recent improvements in image post-processing capabilities help obtain realistic three-dimensional representations of tumors and virtual enteroscopic views of the small bowel that are useful for the surgeon and the gastroenteroenteologist to plan surgical or endoscopic interventions. Along with a better knowledge of the potential and limitations of wireless capsule endoscopy and new endoscopic techniques, these recent developments in radiological imaging reasonably suggest that substantial changes in the investigation of small bowel tumors may be anticipated in a near future, thus potentially create a new paradigm shift after standard small bowel follow-through study has been universally abandoned.
Collapse
Affiliation(s)
- Philippe Soyer
- Department of Abdominal Imaging, Hôpital Lariboisière-AP-HP and Université Diderot-Paris, France.
| | | | | | | | | | | | | |
Collapse
|
15
|
Costa-Silva L, Martins T, Passos MDCF. Enterografia por tomografia computadorizada: experiência inicial na avaliação das doenças do intestino delgado. Radiol Bras 2010. [DOI: 10.1590/s0100-39842010000500008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: O objetivo deste estudo é demonstrar a importância da enterografia por tomografia computadorizada (entero-TC) e como este exame pode contribuir na elucidação diagnóstica e avaliação clínica de pacientes com doenças do intestino delgado. MATERIAIS E MÉTODOS: Análise retrospectiva de 35 pacientes submetidos a entero-TC realizadas em aparelho multidetector de 16 canais, entre maio de 2008 e março de 2009. Utilizou-se meio de contraste iodado venoso e oral neutro (polietilenoglicol). As principais indicações foram avaliação de doença de Crohn, diarreia de origem indeterminada e suspeita de neoplasias. RESULTADOS: Houve boa correlação dos achados à entero-TC relacionados à atividade da doença em pacientes com doença de Crohn, quando comparados com dados clínicos, laboratoriais e endoscópicos. Em 15 casos identificaram-se alterações compatíveis com doença de Crohn, 9 deles sugerindo atividade. Dos pacientes com diarreia, o exame elucidou a maioria dos casos. Identificaram-se dois casos de tumor carcinoide. CONCLUSÃO: A entero-TC é método simples e eficaz para estudo das doenças inflamatórias/neoplásicas do intestino delgado, sobretudo na avaliação da doença de Crohn, indicando atividade da doença. Uma de suas principais vantagens é a possibilidade de avaliação de alterações mesentéricas e extraintestinais associadas.
Collapse
|
16
|
Soyer P, Boudiaf M, Dray X, Fargeaudou Y, Vahedi K, Aout M, Vicaut E, Hamzi L, Rymer R. CT enteroclysis features of uncomplicated celiac disease: retrospective analysis of 44 patients. Radiology 2009; 253:416-24. [PMID: 19864528 DOI: 10.1148/radiol.2532090533] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE To describe the computed tomographic (CT) enteroclysis features of uncomplicated celiac disease (CD) and to determine the most indicative appearance of this condition by using a retrospective case-control study. MATERIALS AND METHODS This study had institutional review board approval. The CT enteroclysis examinations of 44 consecutive patients with proved uncomplicated CD (21 men, 23 women; mean age, 44.45 years) were reviewed by two blinded readers and compared with those obtained in 44 control subjects (21 men, 23 women; mean age, 44.48 years), who were matched for sex and age. Comparisons were calculated by using univariate analysis. RESULTS Reversed jejunoileal fold pattern had the highest specificity (100%; 44 of 44; 95% confidence interval [CI]: 91.96%, 100%) and was the most discriminating independent variable for the diagnosis of uncomplicated CD (odds ratio, 39.9; P < .0001) but had a sensitivity of 63.64% (28 of 44; 95% CI: 47.77%, 77.59%). Ileal fold thickening, vascular engorgement, and splenic atrophy were other variables that strongly correlated with the presence of uncomplicated CD. CONCLUSION CT enteroclysis may help establish a diagnosis of uncomplicated CD and may clarify the cause of nonspecific gastrointestinal symptoms in patients with unknown CD. However, future prospective trials are needed to determine the actual value of CT enteroclysis in patients with CD and validate the clinical usefulness of CT enteroclysis in the detection of unknown uncomplicated CD.
Collapse
Affiliation(s)
- Philippe Soyer
- Department of Abdominal Imaging, and Clinical Research Unit, Hôpital Lariboisière-AP-HP-GHU Nord and Diderot-Paris 7 University, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Crohn’s disease: multi-detector row CT-enteroclysis appearance of the appendix. ACTA ACUST UNITED AC 2009; 35:654-60. [DOI: 10.1007/s00261-009-9575-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Revised: 06/02/2009] [Accepted: 08/31/2009] [Indexed: 12/22/2022]
|
18
|
Abstract
Gastrointestinal stromal tumors (GIST) arising from interstitial cells of Cajal, represent the first type of solid tumor, which is very sensitive to a specific molecularly targeted tyrosine kinase receptor blocker (i. e., imatinib). On CT, which is considered as the reference technique, GISTs typically present as large, well-delineated, heterogeneous and sometimes exophytic masses. In contrast with the absence of lymph node involvement, hepatic metastasis as well as mesenteric involvement can be observed. MR-enteroclysis is indicated to investigate the local extent of the disease in specific cases whereas MR imaging is used to detect hepatic metastasis. Because of a specific treatment, contrast-enhanced imaging is needed for the follow-up of treated tumors. Evaluation of tumor response to treatment is best assessed with CT which still remains the reference imaging technique whereas FDG-PET imaging is used in specific cases.
Collapse
|