MR enterography in the management of patients with Crohn disease.

Crohn disease is a complex pathologic process with an unpredictable lifelong course that includes frequent relapses. It often affects young patients, who are most vulnerable to the potential adverse effects of repeated exposure to ionizing radiation from computed tomography performed for diagnosis and surgical planning. The small intestine is the bowel segment that is most frequently affected, but it is the least accessible with endoscopic techniques.

Extracolonic findings at virtual colonoscopy: an important consideration in asymptomatic colorectal cancer screening.

Background: Virtual colonoscopy has been evaluated for use as a colorectal cancer screening tool, and in prior studies, it has been estimated that the evaluation of extra-colonic findings adds $28-$34 per patient studied.

Methods: As an ancillary study to a prospective cohort study comparing virtual colonoscopy to conventional colonoscopy for colorectal cancer detection, the investigators retrospectively determined the number and estimated costs of all clinic visits, imaging and laboratory studies, and medical procedures that were generated as a direct result of extra-colonic findings at virtual colonoscopy.

Results: We enrolled 143 subjects who underwent CTC followed by conventional colonoscopy.

Cystic changes in hepatic metastases from gastrointestinal stromal tumors (GISTs) treated with Gleevec (imatinib mesylate).

Objective: The purpose of this article is to illustrate the CT findings in patients with hepatic metastases from a gastrointestinal stromal tumor who were treated with STI-571.

Conclusion: Hepatic metastases from gastrointestinal stromal tumors that respond to treatment with STI-571 can appear as near-cystic components with well-defined borders on contrast-enhanced CT. Most metastases became smaller.

Noninvasive assessment of portomesenteric venous thrombosis: current concepts and imaging strategies.

Rapid, noninvasive imaging strategies, especially multidetector spiral CT and CT angiography (CTA) as well as gadolinium-enhanced MR angiography (MRA), have facilitated early diagnosis of splanchnic venous thrombosis, a potentially lethal cause of intestinal ischemia. Single breath-hold volumetric acquisitions permit superior temporal and contrast resolution while eliminating motion artifact and suppressing respiratory misregistration. Increased spatial resolution is aided by thinner slice collimation.

Mesenteric venous thrombosis: diagnosis and noninvasive imaging.

Mesenteric venous thrombosis is an uncommon but potentially lethal cause of bowel ischemia. Several imaging methods are available for diagnosis, each of which has advantages and disadvantages. Doppler ultrasonography allows direct evaluation of the mesenteric and portal veins, provides semiquantitative flow information, and allows Doppler waveform analysis of the visceral vessels; however, it is operator dependent and is often limited by overlying bowel gas.