Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy.
Postgraduate School of Diagnostic and Interventional Radiology, University of Milan, Milan, Italy.
Jpn J Radiol. 2023 Nov;41(11):1208-1215. doi: 10.1007/s11604-023-01456-5. Epub 2023 Jun 21.
The large bowel can be affected by inflammatory bowel diseases, namely ulcerative colitis and Crohn's disease, with the latter occurring either as a unique localization or in conjunction with simultaneous ileal involvement. The differential diagnosis among these conditions is challenging and relies on clinical symptoms, laboratory tests and endoscopy with biopsy. However, as these features can overlap, a conclusive diagnosis is not always achievable, and the underlying cause remains indeterminate. Currently, endoscopy is the reference standard for colonic assessment, although its invasiveness limits its use and repetition within a short timeframe. Magnetic Resonance Enterography is a non-invasive, radiation-free technique that has been extensively and effectively employed in the intestinal evaluation of patients with Crohn's disease in recent years. Although the main goal of this technique is generally focused on evaluating small bowel loops, it can also provide important information about the large bowel if an adequate fulfillment by the oral contrast medium is achieved. The purpose of this work is, therefore, to put emphasis on the potential role of Magnetic Resonance Enterography in assessing the large bowel. In fact, this imaging modality is capable of providing valuable information for comprehensive staging and follow-up of inflammatory bowel diseases within the large bowel, thus complementing the clinical picture and the endoscopic features in the context of a differential diagnosis.
大肠可受到炎症性肠病的影响，即溃疡性结肠炎和克罗恩病，后者可单独发生于某一部位，也可与同时发生的回肠受累并存。这些疾病的鉴别诊断具有挑战性，依赖于临床症状、实验室检查和内镜检查及活检。然而，由于这些特征可能会重叠，因此并非总能做出明确的诊断，且潜在病因仍不确定。目前，内镜检查是结肠评估的参考标准，但由于其侵袭性，限制了其在短期内的使用和重复。磁共振肠造影术是一种非侵入性、无辐射的技术，近年来已广泛、有效地应用于克罗恩病患者的肠道评估。虽然该技术的主要目标通常集中在评估小肠环，但如果口服对比剂能充分充盈，也能提供关于大肠的重要信息。因此，本工作旨在强调磁共振肠造影术在评估大肠方面的潜在作用。事实上，这种影像学方法能够为大肠炎症性肠病的全面分期和随访提供有价值的信息，从而在鉴别诊断中补充临床和内镜特征。
