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Small bowel MRI in Crohn's disease patient

Case Study
Prof. Wentz, Klaus-Ulrich Winterthur, Kantonsspital
Patak, Michael Winterthur, Kantonsspital

Small bowel MRI in patient with Crohn's disease

Patient history:

Patient with Crohn's disease suffers from associated complaints.

MR examination:

The patient has taken 1000 ml 3% Mannitol over 1 hour before the MR examination for optimal distension of the small bowel. 

 

First a 3D B-TFE scan is acquired. Then dynamic 3D T1-TFE scans, pre and post-contrast (20 sec. and 90 sec. after injection).

MR images and interpretation:

3D B-TFE Dynamic 3D T1-TFE Post-contrast MIP
3D B-TFE
Dynamic 3D T1-TFE
Post-contrast MIP
  • The 3D B-TFE image shows bowel wall enhancement and signal increase of surrounding fatty tissue.
  • Dynamic 3D T1-TFE shows bowel wall enhancement after administration of double dose Gd-DOTA.
  • The post-contrast MIP of arterial phase shows typical early enhancement.

 

Preliminary findings in patients with active inflammation associated with Crohn's disease are increased signal intensity on the B-TFE images within the bowel wall and the surrounding fatty tissue. Additionally, post-contrast images show signs of hypervascularity, i.e. the enhancing and thickened sections of the inflamed bowel wall.

Working diagnosis:

Active Crohn's disease.

Impact of using MR imaging for this patient:

The MR procedure is non-invasive and avoids exposing patients to ionizing radiation. The images are of good diagnostic quality.

 



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Case Study
Intera 1.5T
Release 10, Release 9
Body, Small bowel
 

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