Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010346 (Crohn's disease)
 21,615 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Double-contrast magnetic resonance imaging (DC-MRI) is a technique for imaging the intestine, which has shown to be very effective in assessing inflammatory bowel disease (IBD), and particularly Crohn's disease (CD). The expression derives from the association of two different contrast agents, a superparmagnetic intestinal and a paramagnetic intravenous contrast agent. This specific contrast media combination provides optimization of the tissue contrast, both on T1- and T2-weighted images, thus allowing an effective display of small and large bowel loops in normal and pathologic conditions. Therefore, main CD complications (strictures, fistulas, and abscesses), as well as disease activity, may be valuably assessed. The term DC-MRI may also be referred to the typical "double contrast" effect that is produced by this technique at the level of the inflamed bowel wall, both on T1- and T2-weighted images, directly related to the degree of wall inflammation (disease activity).
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PMID:Double-contrast magnetic resonance imaging of the small and large bowel: effectiveness in the evaluation of inflammatory bowel disease. 1908 51

A case of Crohn's disease with an ileo-ileo fistula, ileal strictures and an ileo-cyst fistula is reported. Laparoscopic operation that included partial ileoectomy, ileal stricturoplasty and dissection of the ileo-cyst fistula was performed. Multi-slice computed tomography (MSCT) that was performed before the operation showed an ileo-cyst fistula that was not detected by small bowel follow-through or MRI. In this case, MSCT, including multi-planar reconstruction images, was significantly useful for evaluation of internal fistulas in Crohn's disease.
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PMID:Usefulness of multi-slice CT in a case with internal fistulas in Crohn's disease. 1910 65

Diagnosis and follow-up of inflammatory bowel disease (IBD) in children represent a challenging issue for pediatricians. Nowadays MR studies of the bowel represent a valid diagnostic tool especially in the diagnosis and follow-up of ileal and perianal Crohn's disease in children as well as in adults. The lack of ionizing radiation of MRI enhances the interest of clinicians with respect to CT studies of the bowel in children. Thanks to recent technical development in terms of fast MR images acquisition a reasonable image quality can be easily achieved in scholar-age children. A majority of authors prefer MR-enterography approach in children with respect to the more invasive MR-enteroclysis in the assessment of ileal Crohn's disease. Using rigorous technique of MR-enterography represents a feasible and accurate test in the diagnosis of ileal Crohn's disease. Less experience is collected on MR-colonography in pediatric IBD while MRI of the pelvis represents the most accurate non-invasive diagnostic test in the assessment of perianal Crohn's disease in children as well as in adults.
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PMID:Current status of MR imaging in the evaluation of IBD in a pediatric population of patients. 1914 84

To systematically review the evidence on the accuracy of MRI for grading disease activity in Crohn's disease (CD). The MEDLINE, EMBASE, CINAHL and Cochrane databases were searched for studies on the accuracy of MRI in grading CD compared to a predefined reference standard. Two independent observers scored all relevant data. Three disease stages were defined: remission, mild and frank disease. The accuracy rates of MRI per disease stage were calculated by means of a random-effects model. Seven studies were included from a search resulting in 253 articles. In total 140 patients (16 patients in remission, 29 with mild disease and 95 with frank disease) were used for data analysis. MRI correctly graded 91% (95% CI: 84-96%) of patients with frank disease, 62% (95% CI: 44-79) of patients with mild disease and 62% (95% CI: 38-84) of patients in remission. MRI more often overstaged than understaged disease activity; MRI overstaged disease activity in 38% of patients in remission, mostly as mild disease. Overstaging of mild disease was observed in 21%, understaging in 17%. MRI correctly grades disease activity in a large proportion of patients with frank disease. For patients in remission or with mild disease, MRI correctly stages disease activity in many patients (62%).
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PMID:Magnetic resonance imaging for evaluation of disease activity in Crohn's disease: a systematic review. 1918 9

This study aims to determine inter- and intra-observer variation in MRI measurements of relative bowel wall signal intensity (SI) in Crohn's disease. Twenty-one small bowel MRI examinations (11 male, mean age 40), including T1-weighted acquisitions acquired 30 to 120s post-gadolinium, were analysed. Maximal bowel wall SI (most avid, conspicuous contrast enhancement) in designated diseased segments was measured by two radiologists and two trainees using self-positioned "free" regions of interest (ROIs) followed by "fixed" ROIs chosen by one radiologist, and this procedure was repeated 1 month later. Relative enhancement (post-contrast SI minus pre-contrast SI/pre-contrast SI) was calculated. Data were analysed using Bland-Altman limits of agreement and intra-class correlation. Inter-observer agreement for relative enhancement was poor (spanning over 120%) using a free ROI-95% limits of agreement -0.69, 0.70 and -0.47, 0.74 for radiologists and trainees, respectively, only marginally improved by use of a fixed ROI -0.60, 0.67 and -0.59, 0.49. Intra-class correlation ranged from 0.46 to 0.72. Intra-observer agreement was slightly better and optimised using a fixed ROI-95% limits of agreement -0.52, 0.50 and -0.34, 0.28 for radiologists and trainees, respectively. Intra-class correlation ranged from 0.49 to 0.86. Relative bowel wall signal intensity measurements demonstrate wide limits of observer agreement, unrelated to reader experience but improved using fixed ROIs.
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PMID:MRI of small bowel Crohn's disease: determining the reproducibility of bowel wall gadolinium enhancement measurements. 1930 16

At DDW 2008 around 1000 abstracts on inflammatory bowel disease were presented. Our goal in this report is to summarize the most important new data on diagnosis, smoking and cancer related to IBD. MRI is emerging as a basic diagnostic tool in Crohn's disease. New data are accumulating demonstrating that smoking has a negative impact on natural history of CD even when treated in very specialized units, and with moderate tobacco use. When population-based studies are considered, colorectal cancer is not so a frequent complication as has been reported in referente centres. However, its incident does fully justify surveillance, although more and more data show that the key point to diminish the incidence of cancer is a good control of inflammation.
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PMID:[Inflammatory bowel disease]. 1943 65

Recto-urethral fistulas in Crohn's disease are rare, and managing them is difficult. The various surgical techniques are not reliably effective and are associated with a significant risk of morbidity. The rectal mucosal transposition flap technique, which is used most frequently, requires the rectal mucosa to be in a healthy condition. We report here on a case where treatment was by injecting fibrin glue into a complex fistula with a single anorectal point of origin but combining a median recto-urethrocutaneous tract with two deep lateral rectoperineal tracts. The patient had presented with active rectal Crohn's disease. This treatment produced complete closure, verified by MRI, of all the fistula tracts, which was still maintained after three years, and with normal anal continence. When confronted with this type of fistula, and particularly when the condition of the rectal mucosa is poor, the specialist should be encouraged by this good result to consider the injection of fibrin glue, a technique without risk of morbidity, as a first course of action.
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PMID:Fibrin glue sealing in the treatment of a recto-urethral fistula in Crohn's disease: a case report. 1947 14

Diagnosing Crohn's disease in the small intestine can be troublesome. Traditionally, the small bowel is evaluated by ileocolonoscopy and small bowel follow-through or enteroclysis. In recent years MRI, CT, ultrasound and capsule endoscopy have emerged. All are validated and implemented in clinical practice. Double-balloon enteroscopy, PET-CT and SPECT are newer methods, which are still being evaluated in clinical trials. The purpose of this article is to review clinical studies focusing on the validity of modalities for diagnosing Crohn's disease of the small intestine.
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PMID:[Diagnostic imaging and endoscopic methods in Crohn's disease of the small intestine]. 1973 20

Stenosis is the most frequent complication during Crohn's disease. The lesion can be inflammatory, or due to a fibrosing or neoplastic process. The medical treatment with anti-inflammatory drugs is usually sufficient as first line treatment; fibrous lesions require endoscopic or surgical procedures while neoplastic lesions require surgery. A multidisciplinary approach (radiologic, medical, surgical and endoscopic) is needed. In a first part, we discuss the definition of stenosis and the modalities of imaging (particularly MRI) and of treatment (particularly with TNFalpha antagonists). Then we expose the strategy for the management of the most frequent clinical situations: occlusion, ileal inflammatory stenosis, stenosis of an ileocolonic anastomosis and chronic fibrous stenosis. The treatment decision takes into account the results of radiological assessment, CRP level and the effects of the previous treatments.
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PMID:[Management of ileal stenosis in patients with Crohn's disease]. 1973 58

The association of inflammatory bowel disease with neurological involvement is unusual and often controversial. We report the case of a 39-year old man with Crohn's disease and an intracranial benign primary tumor, detected on MRI scan. The patient had been suffering from extensive perianal fistulas for 8 years, before inflammatory bowel disease was diagnosed six months ago. The patient, being enrolled in a research protocol, underwent brain MRI examination. Despite the absence of neurological symptoms and electromyography abnormalities, a meningioma was evidenced. Whether this is an incidental finding on brain MRI or whether it might be linked to Crohn's disease development as an extraintestinal, neurological disorder remains unclear. This information is especially important in view of the ethical and practical issues involved in the management of incidental findings in CD. This report might provide further confirmation of the hypothesis that central neurological disorders occur during CD.
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PMID:Asymptomatic brain finding results on MRI in a patient with Crohn's disease: a case report. 2007 23


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