Role of Magnetic Resonance Enteroclysis in the Assessment of Pathologies of Small Bowel
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Date
2024-08
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International Research Organization for Life & Health Sciences
Abstract
background: Examination of the gastrointestinal (GI) tract for both anatomy and pathology is essential in diagnosing GI diseases. Traditional radiology has historically played a pivotal role, alongside endoscopy which remains primary despite limitations. However, non-invasive cross-sectional imaging modalities such as ultrasound (US), computed tomography (CT), positron-emission tomography (PET), and magnetic resonance imaging (MRI) have revolutionized GI tract assessment. These modalities offer enhanced resolution, 3D imaging, and contrast enhancement, with multimodal approaches such as PET-CT and PET-MRI improving sensitivity and specificity in tissue pathology studies. US, due to its affordability, non- invasiveness, and high diagnostic accuracy, has gained prominence in GI disease diagnosis, particularly with Doppler and contrast-enhanced US providing critical blood flow data. Magnetic resonance enteroclysis (MRE) has emerged as a standard imaging test for evaluating small-bowel (SB) pathologies, necessitating standardized practices in indications, interpretation, and methodology. MRE accurately assesses intraluminal, parietal, and extraluminal aspects of the SB, distinguishing between neoplastic and non-neoplastic diseases. This study aims to present the MRE technique, interpret imaging findings, and compare them with final diagnoses, emphasizing its role and advantages in diagnosing SB pathologies through rigorous methodological steps. Objective: This study evaluates the role of MRE in diagnosing SB pathologies, including inflammatory bowel diseases (IBD) and their extraluminal complications and extraintestinal manifestations. It focuses on assessing disease activity, treatment response, and distinguishing inflammatory from fibrotic strictures in conditions such as Crohn’s disease (CD) and ulcerative colitis (UC). Materials and Methods: A retrospective and prospective study conducted over 5 years starting from May 2019 to July 2024 (5 years) at the Department of Radiology, Sri Ramachandra Institute of Higher Education and Research, involved 34 patients with various SB pathologies undergoing MRE. Clinical and histopathological evaluations were compared with MRE findings. Statistical analysis determined the sensitivity and specificity of MRE as a diagnostic tool. Results: The study showed a slight male predominance among patients, with ages ranging from 1 to 80 years, most commonly affected between 21 and 40 years. Common symptoms included abdominal pain, vomiting, weight loss, and diarrhea. MRE identified bowel wall thickening, strictures, fat stranding, fistulas, lymph node enlargement, and ascites, with CD being the most prevalent diagnosis. Histopathological examination confirmed IBD in the majority as well as other pathologies such as tuberculosis and validating MRE diagnoses. Conclusion: MRE proves effective in diagnosing a wide range of GI pathologies, particularly inflammatory small-bowel disorders such as CD and UC. Its comprehensive imaging capabilities provide crucial insights for precise diagnosis and treatment planning, making it a preferred first-line imaging technique due to its non-invasiveness and absence of radiation exposure.
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Keywords
Acute myeloid leukaemia, Chloromas, Extramedullary ovarian granulocytic sarcoma/chloroma, Granulocytic sarcomas, Hematopoietic and lymphoid tissues, Leukemia; Myelogenous; Chronic; BCR-ABL Positive, Leukemia; Myeloid; Acute, Leukemia; Promyelocytic; Acute, Myelodysplastic Syndromes, Myeloid precursor cells, Myeloid sarcoma (granulocytic sarcoma or chloroma), Ovarian granulocytic sarcoma, Primary ovarian granulocytic sarcoma, Sarcoma; Myeloid
Citation
Thirukoveluri R.. Role of Magnetic Resonance Enteroclysis in the Assessment of Pathologies of Small Bowel. International Journal of Scientific Study. 2024 Aug; 12(5): 38-55