Friday, November 17, 2017

Enterography.


















 












 








 









 



 












Patient with active distal ileal Crohn’s disease: a) axial HASTE image shows bowel wall is of intermediate signal (arrow) due to submucosal oedema. Mesenteric oedema (asterisk) is also noted; b) corresponding axial T1 fat-saturated post-contrast image shows avid stratified pattern of mural enhancement (arrow)



Patient with active distal colitis: a axial HASTE image shows very high signal in the submucosa in keeping with oedema (arrow); b corresponding axial T1 fat-saturated post-contrast image shows avid stratified pattern of mural enhancement (arrow)



Example of fibrostenotic disease: coronal HASTE image shows a stricture in the neoterminal ileum in a patient with previous ileocolic resection; this is of intermediate to low signal due to little mural oedema (arrows); there is pre-stenotic dilatation










Example of comb sign in active inflammation: coronal True FISP image shows multiple linear low signal structures extending to the bowel wall in keeping with engorged vasa recta (arrows) supplying the thickened terminal ileum (asterisk). Note the fibrofatty proliferation within the adjacent mesentery, separating the inflamed terminal ileum from adjacent loops of bowel, with small mesenteric nodes also present








Example of DWI in active inflammation: a axial T1 fat-saturated post-contrast image shows thickened enhancing ileum with typical stratified enhancement pattern (arrow); b corresponding DWI (b = 800) and c ADC map confirm restricted diffusion with persistent high signal (arrow) on the DWI and low signal (arrow) on the ADC map (ROI = 1,200)

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