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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Shrnutí: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
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ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-015-4098-0