Magnetic resonance enterography/enteroclysis in acquired small bowel diverticulitis and small bowel diverticulosis

Purpose Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging. Magnetic resonance enterography/enteroclysis (MRE) is increasingly used to assess SB disease; awareness of the appearance of SB diverticuli...

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Vydané v:	European radiology Ročník 26; číslo 9; s. 2881 - 2891
Hlavní autori:	Mansoori, Bahar, Delaney, Conor P., Willis, Joseph E., Paspulati, Raj M., Ros, Pablo R., Schmid-Tannwald, Christine, Herrmann, Karin A.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2016 Springer Nature B.V
Predmet:	Abdomen Abscesses Adult Aged Bowel disease Diagnostic Radiology Diverticulitis Diverticulitis - diagnostic imaging Diverticulitis - pathology Diverticulum - diagnostic imaging Diverticulum - pathology Female Hospitals Humans Imaging Inflammation Internal Medicine Interventional Radiology Intestine, Small - diagnostic imaging Intestine, Small - pathology Magnetic Resonance Magnetic Resonance Imaging - methods Male Medicine Medicine & Public Health Middle Aged Neuroradiology Patients Peritonitis Radiology Retrospective Studies Surgery Ultrasound United States > US Germany MR enterography Inflammatory bowel disease Small bowel disease Diverticulitis MR enteroclysis
ISSN:	0938-7994, 1432-1084
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Abstract	Purpose Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging. Magnetic resonance enterography/enteroclysis (MRE) is increasingly used to assess SB disease; awareness of the appearance of SB diverticulitis is essential to ensure appropriate management. Our aim was to systematically describe imaging characteristics of SB diverticulosis and diverticulitis in MRE. Methods This retrospective, HIPAA-compliant study identified 186 patients with suspected SB diverticulosis/diverticulitis in medical databases of two tertiary medical centres between 2005 and 2011. Patients with surgically confirmed diagnoses of SB diverticulosis/diverticulitis were included. Two observers analyzed MR images for the presence, location, number, and size of diverticula, wall thickness, and mural and extramural patterns of inflammation. Results Seven patients were recruited. MRI analysis showed multiple diverticula in all (100 %). Diverticular size ranged from 0.5 to 6 cm. Prevalence of diverticula was higher in the proximal than the distal SB (jejunum 86 %, ileum 57 %, distal ileum43%). Diverticulitis occurred in 3/7 patients (43 %) showing asymmetric bowel wall thickening and focal mesenteric inflammation. Conclusion SB diverticulitis demonstrates characteristic MRE imaging features to distinguish this rare disorder from more common diseases. Asymmetric, focal mesenteric and mural inflammation and presence of multiple diverticula are keys to diagnosis. Key points • Small bowel diverticulosis and diverticulitis is rare and often missed in imaging • Acquired small bowel diverticula are variable in size and number • Small bowel diverticulitis demonstrates characteristic features on MR enterography/enteroclysis • A focal or segmental asymmetric small bowel inflammation should prompt the search for diverticula
AbstractList	Purpose Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging. Magnetic resonance enterography/enteroclysis (MRE) is increasingly used to assess SB disease; awareness of the appearance of SB diverticulitis is essential to ensure appropriate management. Our aim was to systematically describe imaging characteristics of SB diverticulosis and diverticulitis in MRE. Methods This retrospective, HIPAA-compliant study identified 186 patients with suspected SB diverticulosis/diverticulitis in medical databases of two tertiary medical centres between 2005 and 2011. Patients with surgically confirmed diagnoses of SB diverticulosis/diverticulitis were included. Two observers analyzed MR images for the presence, location, number, and size of diverticula, wall thickness, and mural and extramural patterns of inflammation. Results Seven patients were recruited. MRI analysis showed multiple diverticula in all (100 %). Diverticular size ranged from 0.5 to 6 cm. Prevalence of diverticula was higher in the proximal than the distal SB (jejunum 86 %, ileum 57 %, distal ileum43%). Diverticulitis occurred in 3/7 patients (43 %) showing asymmetric bowel wall thickening and focal mesenteric inflammation. Conclusion SB diverticulitis demonstrates characteristic MRE imaging features to distinguish this rare disorder from more common diseases. Asymmetric, focal mesenteric and mural inflammation and presence of multiple diverticula are keys to diagnosis. Key points • Small bowel diverticulosis and diverticulitis is rare and often missed in imaging • Acquired small bowel diverticula are variable in size and number • Small bowel diverticulitis demonstrates characteristic features on MR enterography/enteroclysis • A focal or segmental asymmetric small bowel inflammation should prompt the search for diverticula Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging. Magnetic resonance enterography/enteroclysis (MRE) is increasingly used to assess SB disease; awareness of the appearance of SB diverticulitis is essential to ensure appropriate management. Our aim was to systematically describe imaging characteristics of SB diverticulosis and diverticulitis in MRE. This retrospective, HIPAA-compliant study identified 186 patients with suspected SB diverticulosis/diverticulitis in medical databases of two tertiary medical centres between 2005 and 2011. Patients with surgically confirmed diagnoses of SB diverticulosis/diverticulitis were included. Two observers analyzed MR images for the presence, location, number, and size of diverticula, wall thickness, and mural and extramural patterns of inflammation. Seven patients were recruited. MRI analysis showed multiple diverticula in all (100 %). Diverticular size ranged from 0.5 to 6 cm. Prevalence of diverticula was higher in the proximal than the distal SB (jejunum 86 %, ileum 57 %, distal ileum43%). Diverticulitis occurred in 3/7 patients (43 %) showing asymmetric bowel wall thickening and focal mesenteric inflammation. SB diverticulitis demonstrates characteristic MRE imaging features to distinguish this rare disorder from more common diseases. Asymmetric, focal mesenteric and mural inflammation and presence of multiple diverticula are keys to diagnosis. times Small bowel diverticulosis and diverticulitis is rare and often missed in imaging times Acquired small bowel diverticula are variable in size and number times Small bowel diverticulitis demonstrates characteristic features on MR enterography/enteroclysis times A focal or segmental asymmetric small bowel inflammation should prompt the search for diverticula PURPOSESmall bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging. Magnetic resonance enterography/enteroclysis (MRE) is increasingly used to assess SB disease; awareness of the appearance of SB diverticulitis is essential to ensure appropriate management. Our aim was to systematically describe imaging characteristics of SB diverticulosis and diverticulitis in MRE.METHODSThis retrospective, HIPAA-compliant study identified 186 patients with suspected SB diverticulosis/diverticulitis in medical databases of two tertiary medical centres between 2005 and 2011. Patients with surgically confirmed diagnoses of SB diverticulosis/diverticulitis were included. Two observers analyzed MR images for the presence, location, number, and size of diverticula, wall thickness, and mural and extramural patterns of inflammation.RESULTSSeven patients were recruited. MRI analysis showed multiple diverticula in all (100 %). Diverticular size ranged from 0.5 to 6 cm. Prevalence of diverticula was higher in the proximal than the distal SB (jejunum 86 %, ileum 57 %, distal ileum43%). Diverticulitis occurred in 3/7 patients (43 %) showing asymmetric bowel wall thickening and focal mesenteric inflammation.CONCLUSIONSB diverticulitis demonstrates characteristic MRE imaging features to distinguish this rare disorder from more common diseases. Asymmetric, focal mesenteric and mural inflammation and presence of multiple diverticula are keys to diagnosis.KEY POINTS• Small bowel diverticulosis and diverticulitis is rare and often missed in imaging • Acquired small bowel diverticula are variable in size and number • Small bowel diverticulitis demonstrates characteristic features on MR enterography/enteroclysis • A focal or segmental asymmetric small bowel inflammation should prompt the search for diverticula. Purpose Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging. Magnetic resonance enterography/enteroclysis (MRE) is increasingly used to assess SB disease; awareness of the appearance of SB diverticulitis is essential to ensure appropriate management. Our aim was to systematically describe imaging characteristics of SB diverticulosis and diverticulitis in MRE. Methods This retrospective, HIPAA-compliant study identified 186 patients with suspected SB diverticulosis/diverticulitis in medical databases of two tertiary medical centres between 2005 and 2011. Patients with surgically confirmed diagnoses of SB diverticulosis/diverticulitis were included. Two observers analyzed MR images for the presence, location, number, and size of diverticula, wall thickness, and mural and extramural patterns of inflammation. Results Seven patients were recruited. MRI analysis showed multiple diverticula in all (100 %). Diverticular size ranged from 0.5 to 6 cm. Prevalence of diverticula was higher in the proximal than the distal SB (jejunum 86 %, ileum 57 %, distal ileum43%). Diverticulitis occurred in 3/7 patients (43 %) showing asymmetric bowel wall thickening and focal mesenteric inflammation. Conclusion SB diverticulitis demonstrates characteristic MRE imaging features to distinguish this rare disorder from more common diseases. Asymmetric, focal mesenteric and mural inflammation and presence of multiple diverticula are keys to diagnosis. Key points * Small bowel diverticulosis and diverticulitis is rare and often missed in imaging * Acquired small bowel diverticula are variable in size and number * Small bowel diverticulitis demonstrates characteristic features on MR enterography/enteroclysis * A focal or segmental asymmetric small bowel inflammation should prompt the search for diverticula Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging. Magnetic resonance enterography/enteroclysis (MRE) is increasingly used to assess SB disease; awareness of the appearance of SB diverticulitis is essential to ensure appropriate management. Our aim was to systematically describe imaging characteristics of SB diverticulosis and diverticulitis in MRE. This retrospective, HIPAA-compliant study identified 186 patients with suspected SB diverticulosis/diverticulitis in medical databases of two tertiary medical centres between 2005 and 2011. Patients with surgically confirmed diagnoses of SB diverticulosis/diverticulitis were included. Two observers analyzed MR images for the presence, location, number, and size of diverticula, wall thickness, and mural and extramural patterns of inflammation. Seven patients were recruited. MRI analysis showed multiple diverticula in all (100 %). Diverticular size ranged from 0.5 to 6 cm. Prevalence of diverticula was higher in the proximal than the distal SB (jejunum 86 %, ileum 57 %, distal ileum43%). Diverticulitis occurred in 3/7 patients (43 %) showing asymmetric bowel wall thickening and focal mesenteric inflammation. SB diverticulitis demonstrates characteristic MRE imaging features to distinguish this rare disorder from more common diseases. Asymmetric, focal mesenteric and mural inflammation and presence of multiple diverticula are keys to diagnosis. • Small bowel diverticulosis and diverticulitis is rare and often missed in imaging • Acquired small bowel diverticula are variable in size and number • Small bowel diverticulitis demonstrates characteristic features on MR enterography/enteroclysis • A focal or segmental asymmetric small bowel inflammation should prompt the search for diverticula.
Author	Ros, Pablo R. Mansoori, Bahar Willis, Joseph E. Schmid-Tannwald, Christine Herrmann, Karin A. Paspulati, Raj M. Delaney, Conor P.
Author_xml	– sequence: 1 givenname: Bahar surname: Mansoori fullname: Mansoori, Bahar organization: Department of Radiology, University Hospitals Case Medical Center – sequence: 2 givenname: Conor P. surname: Delaney fullname: Delaney, Conor P. organization: Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center – sequence: 3 givenname: Joseph E. surname: Willis fullname: Willis, Joseph E. organization: Department of Pathology, University Hospitals Case Medical Center – sequence: 4 givenname: Raj M. surname: Paspulati fullname: Paspulati, Raj M. organization: Department of Radiology, University Hospitals Case Medical Center, Department of Radiology, Case Western Reserve University – sequence: 5 givenname: Pablo R. surname: Ros fullname: Ros, Pablo R. organization: Department of Radiology, University Hospitals Case Medical Center, Department of Radiology, Case Western Reserve University – sequence: 6 givenname: Christine surname: Schmid-Tannwald fullname: Schmid-Tannwald, Christine organization: Department of Radiology, University Hospitals Munich – sequence: 7 givenname: Karin A. surname: Herrmann fullname: Herrmann, Karin A. email: Karin.Herrmann@uhhospitals.org organization: Department of Radiology, University Hospitals Case Medical Center, Department of Radiology, Case Western Reserve University, University Hospitals Case Medical Center, Case Western Reserve University
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/26597545$$D View this record in MEDLINE/PubMed
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CitedBy_id	crossref_primary_10_1038_s41598_019_50501_9 crossref_primary_10_1007_s10140_016_1448_4 crossref_primary_10_1016_j_crad_2021_12_003 crossref_primary_10_1007_s00261_019_01928_1 crossref_primary_10_1136_bcr_2020_240923 crossref_primary_10_1002_ccr3_7033 crossref_primary_10_1007_s00247_018_4166_0 crossref_primary_10_1155_2019_2548631 crossref_primary_10_1007_s11894_019_0741_2 crossref_primary_10_1016_j_lpm_2017_08_009
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Snippet	Purpose Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in... Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging.... Purpose Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in... PURPOSESmall bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging....
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SubjectTerms	Abdomen Abscesses Adult Aged Bowel disease Diagnostic Radiology Diverticulitis Diverticulitis - diagnostic imaging Diverticulitis - pathology Diverticulum - diagnostic imaging Diverticulum - pathology Female Hospitals Humans Imaging Inflammation Internal Medicine Interventional Radiology Intestine, Small - diagnostic imaging Intestine, Small - pathology Magnetic Resonance Magnetic Resonance Imaging - methods Male Medicine Medicine & Public Health Middle Aged Neuroradiology Patients Peritonitis Radiology Retrospective Studies Surgery Ultrasound
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Title	Magnetic resonance enterography/enteroclysis in acquired small bowel diverticulitis and small bowel diverticulosis
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