NYU Langone Health, 660 First Ave, 3rd Fl, New York, NY 10016.
Cleveland Clinic, Cleveland, OH.
AJR Am J Roentgenol. 2021 Aug;217(2):347-358. doi: 10.2214/AJR.20.24031. Epub 2020 Sep 16.
Ileal pouch-anal anastomosis (IPAA) surgery is the reference standard surgical procedure for treatment of ulcerative colitis and most patients with familial adenomatous polyposis. This procedure allows preservation of fecal continence and gastrointestinal continuity. However, it is associated with a wide variety of complications, which often have nonspecific and overlapping clinical presentations, making imaging an important part of workup for pouch dysfunction. The purpose of this article is to propose structured reporting templates for MRI and water-soluble contrast enema (WSCE), based on our referral pouch center's experience, in patients who have undergone IPAA surgery. We review salient surgical technique, pouch anatomy, and imaging protocols, with an emphasis on a systematic search pattern for evaluation of ileal pouch complications using proposed structured reporting templates for MRI and WSCE.
回肠贮袋-肛管吻合术(IPAA)是治疗溃疡性结肠炎和大多数家族性腺瘤性息肉病患者的标准参考手术。该手术可保留粪便控制和胃肠道连续性。然而,它与多种并发症相关,这些并发症通常具有非特异性和重叠的临床表现,使影像学成为 pouch 功能障碍评估的重要组成部分。本文旨在基于我们 referral pouch 中心的经验,为接受 IPAA 手术的患者提出 MRI 和水溶性对比灌肠(WSCE)的结构化报告模板。我们回顾了相关的手术技术、贮袋解剖和影像学方案,重点是使用 MRI 和 WSCE 的结构化报告模板对 ileal pouch 并发症进行系统搜索评估。