0:01

Okay.

0:01

Here's another case showing additional features

0:04

of enhancement that we need to discuss.

0:06

So there's a little bit of motion in this case, but

0:07

I think it's a good case for a number of reasons.

0:10

One thing is this, as opposed to that kind of

0:15

bi laminar or inter wall hyper enhancement,

0:17

this has a nice diffuse enhancement

0:18

pattern throughout much of the ball.

0:21

But that diffuse enhancement pattern

0:22

also is not really entirely specific.

0:25

So a lot of things can cause a

0:26

diffuse ball enhancement like this.

0:29

including things like infiltrative

0:31

diseases, ischemia, or shock bowel.

0:34

However, in this case, there's a reason why I think

0:37

this case is much more specific for Crohn's disease.

0:40

And that's because in addition to that diffuse

0:42

enhancement, there are areas of the bowel

0:43

that have more of an asymmetric enhancement.

0:46

And so if you see asymmetric enhancement,

0:48

where the bowel is enhancing more on the

0:50

mesenteric side than the anti mesenteric side,

0:53

That's very specific for Crohn's disease.

0:55

There aren't other diseases that typically

0:57

show that type of enhancement pattern.

1:00

And so here, on this segment of ball, you see

1:02

this diffuse enhancement, but then you see

1:04

another area where you've got enhancement of this

1:06

mesenteric side, while the anti mesenteric side.

1:09

is a little bit dilated and with some

1:11

sacculated appearance, which we'll talk about

1:12

more later, but also it's just not enhancing.

1:15

And that indicates a specific

1:18

finding for Crohn's disease.

1:19

So keep that in mind when you get that question is,

1:22

could there be some other cause for inflammation?

1:24

Well, if you see this, you can be fairly confident

1:27

that you're dealing with Crohn's disease.