Main description:

This second edition is primarily dedicated to MR-Enterography, an imaging modality whose reliability for intestinal assessment in patients suffering from inflammatory bowel diseases has gained increasing consensus.

The performance of this technique has been significantly enlarged over the last years, due to its undoubted advantages in terms of exhaustive evaluation of the abdominal cavity and safeness due to the lack of radiation exposure.

The first part is focused on MR-Enterography standard protocol. Nevertheless, additional sequences, technical novelties and common pitfalls are reported and discussed.

In the second section, the typical intestinal and extra-intestinal findings related to Crohn's disease are described in detail. In this edition, more emphasis has been put on practical topics, useful in the daily clinical practice: anatomical changes after surgical procedures, structured reporting and emerging clinical applications over inflammatory bowel diseases.

Another part is dedicated to Magnetic Resonance Imaging of the anal canal, including technical aspects and clinical implications.

The text is largely complemented by diagnostic images. Nonetheless, at the end of the book 30 illustrated cases show different clinical scenarios evaluated with MR-Enterography and Magnetic Resonance Imaging of the anal canal.

Contents:

1. Introduction (S. Mazziotti, A. Blandino, G. Cicero)

2. Small bowel Imaging (C. Booz, S. Martin, I. Yel, T. J. Vogl)

2.1 X-ray and Fluoroscopy

2.2 Ultrasound

2.3 Computed Tomography

3. MR-Enterography: Technique (T. D'Angelo, S. Mazziotti, G. Ascenti, G. Cicero)

3.1 Enteric Contrast Agents

3.2 Patient's Preparation and Positioning

3.3 Protocols and Sequences

3.3.1 Half-Fourier Acquisition

Single-Shot Turbo Spin Echo (HASTE)

3.3.2 Balanced Steady-State Free

Precession (Balanced SSFP)

3.3.3 Pre- and Post-contrast

T1-Weighted Ultrafast Gradient Echo

3.4 Spasmolytics

3.5 Intravenous Contrast Agent

3.6 Advanced MR Techniques

3.6.1 MR Fluoroscopy

3.6.2 Cine MR

3.6.3 Diffusion-Weighted Imaging

3.6.4 Perfusion (DCE-MRI)

3.6.5 Technical novelties and future perspectives

4 MR-Enterography: Anatomy (T. D'Angelo, S. Mazziotti, G. Ascenti, G. Cicero)

4.1 Normal MR Anatomy of Duodenum and Small Bowel

4.2 Normal MR Anatomy of Sphincters and Perianal Region

4.3 Anatomical changes after surgery: types of interventions and anastomosis

5 MR-Enterography intestinal findings in Crohn's Disease (G. Cicero, S. Mazziotti, A. Blandino, T. D'Angelo)

5.1 Wall Thickening

5.2 Ulcerations

5.3 Increased Vascularity

5.4 Patterns of Wall Enhancement

5.5 Perienteric Inflammation

5.6 Reactive Adenopathy

5.7 Mesenteric Fibrofatty Proliferation

5.8 Penetrating and Stricturing

Patterns in CD

5.8.1 Penetrating Disease

5.8.2 Fibrostenosing Disease

6 Extraintestinal Complications in Crohn's disease: MR-Enterography findings (T. D'Angelo, S. Mazziotti, A. Blandino, G. Cicero)

6.1 Hepatobiliary Complications

6.1.1 Primary Sclerosing Cholangitis

6.1.2 Gallstone Disease

6.1.3 Liver Abscess

6.1.4 Portal Vein Thrombosis

6.2 Pancreatic Complications

6.3 Genitourinary Complications

6.3.1 Ureteral Obstruction

6.3.2 Nephrolithiasis

6.3.3 Genitourinary Tract Fistulas

6.4 Musculoskeletal and Cutaneous Manifestations

6.5 Peritoneal Involvement

7 MR-Enterography beyond Crohn's disease (G. Cicero, T. D'Angelo, G. Ascenti, S. Mazziotti)

7.1. Congenital anomalies

7.2 Inflammatory conditions

7.3 Benign and Malignant lesions

8. Pitfalls in MRE (T. D'Angelo, S. Mazziotti, G. Ascenti, G. Cicero)

9 MRI of the anal region in Crohn's disease (S. Mazziotti, G. Cicero, A. Blandino, T. D'Angelo)

9.1 Classification of fistulas

9.2 Technique

9.3 Perianal findings in Crohn's disease

9.4 MRI of the anal canal beyond Crohn's disease

10. Structured reporting (C. Booz, S. Martin, I. Yel, T. J. Vogl)

10.1 MR-Enterography

10.2 Perianal MRI

11. Clinical Cases

11.1. 25 MR-Enterography clinical cases

11.2 5 MRI perianal involvement cases