H Malíková | PubMed Health

PubMed2006

[Our first experience with CT enteroclysis].

BACKGROUND: Small intestine belongs to abdominal organs which are difficult to imagine. Methods of examination have therefore continuously improved in order to get better picture of the intestine. METHODS AND RESULTS: CT enteroclysis represents a modern method of the small intestine imagining which combines classical enteroclysis with spiral abdominal CT. Small intestine is filled with negative contrast material applied by an enteric tube. The negative contrast material optimises visualisation of the intestinal wall, namely after the enhancement using iodine intravenous contrast. Within 23 months we examined 33 patients with gastroenterological indication using CT enteroclysis. In 31 cases results were technically satisfactory, small intestine was well filled by the negative contrast material and sufficiently distended. According to clinical indications patients were classified into four groups. Group A: 10 patients with problematic indications. No pathological changes were found in this group. Group B: 8 patients suspected of Crohn's disease. Only two cases were negative in this group. In 6 cases signs of inflammation in the small or large intestine were found. Group C: 6 patients after the surgical treatment of Crohn's disease, suspected of the recurrence. All patients had signs of the recurrence. Group D: 7 patients with various clinical diagnoses. Examination was in 2 cases negative, in other 5 cases some pathological changes of the intestine were found: Icase of malabsorption, 3 cases of adhesion and hernia, 1 case of intestinal inflammation with covered perforation and inter-intestinal abscess. CONCLUSIONS: CT enteroclysis was confirmed to be effective method for high quality imaging of the small intestine with associated tissues and the whole abdominal cavity. However, it is a method with represent irradiation, stress of intravenous administration of the contrast material and the discomfort related to enteric tube. Examination should not be indicated in cases of the problematic diagnosis only. However, in cases of correct indication signs of pathology were frequently confirmed.

Adult↗

PubMed2003

[Initial experience with magnetic resonance cholangiopancreatography].

BACKGROUND: Magnetic resonance cholangiopancreaticography (MRCP) is based on heavily weighted T2 sequences (ETSE--echo-train spin echo) with suppression of fat, giving visualisation of slowly flowing or stagnating fluid. MRCP are short sequences in coronary plane with thickness of 8 cm or 4 mm. Retrospective analysis of all MRCP examinations performed during last 12 months is presented. METHODS AND RESULTS: Eighty-eight examinations were done, of which 67 ones with both adequate technical quality and clinical indication were included into the study (20 males aged 25-83 years, 47 women aged 19-82 years). Patients were divided into 4 groups regarding to the indications (group I.--temporary cholestasis, normal abdominal ultrasound, II.--definite cholestasis, III.--pathologic findings on pancreas, IV.--other). Vast majority of patients were included into group I (35 subjects). In 7 (20%) of them choledocholithiasis and/or stenoses (including multiple stenoses in primary sclerotizing cholangoitis) were found. MRCP brought diagnostic information in subjects with cholestasis (group II.) and answered questions given by clinicians. However, in 1 of 4 subjects with primary sclerotizing cholangoitis, MRCP did not reveal intra-hepatic stenoses, which were later visualised by classical ERCP. Only the extrahepatic stenoses were diagnosed by MRCP in the latter subject. CONCLUSIONS: MRCP should become a standard examination in the diagnostic algorithm in patients with cholangiopathies. MRCP has its value not only in subjects with unsuccessful or contraindicated ERCP, but also in subjects with temporary cholestasis with negative ultrasound finding.

Adult↗