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1 topic, 3 min.
47 topics, 2 hr. 18 min.
Introduction to Crohn’s
1 m.Enterography Technique
3 m.T2 Sequences Part 1
3 m.T2 Sequences Part 2
3 m.Dynamic Sequences
3 m.Additional Sequences
3 m.Imaging of Crohn’s Disease
4 m.Improper Glucagon Administration
1 m.Normal Coronal Anatomy on MRI
2 m.Active Inflammation Overview
3 m.Segmental Mural Hyper Enhancement
2 m.Inner Wall Hyper Enhancement
2 m.Additional Patterns of Hyper Enhancement
2 m.Assessing Wall Thickening
3 m.Assessing Bowel Wall Edema
3 m.Using Diffusion Sequences to Increase Sensitivity
3 m.Using Diffusion For Lymph Adenopathy
2 m.Sacculations As a Finding – Crohn’s Disease
2 m.Using Cine for Identifying Disease
2 m.Identifying Strictures
3 m.Distinguishing Inflammation from Fibrotic Disease
4 m.Sacculation
4 m.Acute Inflammation
3 m.Changes in Fat with Chronic Disease
4 m.Indications for Surgery Part 1
2 m.Indications for Surgery Part 2
3 m.Ileal Fistula
4 m.Severe Disease w/ Abscess
4 m.Classic Fistula Appearances
2 m.Crohn’s vs. UC
2 m.Severe Ulceritive Colitis
20 m.Crohn’s Colitis
2 m.Colonic Inflammation
3 m.Fistula to Colon w/ Post Op Imaging
5 m.Recurrent Crohn’s Disease
2 m.Mild Anastamotic Inflammation
3 m.Extraintestinal Manifestations
2 m.Sacroiliitis
2 m.Primary Sclerosing Cholangitis
2 m.CT Vs. MRI – Crohn’s
5 m.Transient Intussusception
2 m.Pneumatosis
3 m.Generating a Crohn’s Report
7 m.Detecting and Characterizing Crohn’s Disease Part 1
7 m.Detecting and Characterizing Part 2
4 m.Characterizing a Complex Fistula
7 m.Crohn’s Summary
1 m.0:01
All right, here we have another case of
0:03
inflammatory bowel disease involving the colon.
0:06
In this case, what we see is clear
0:08
hyperenhancement in the sigmoid colon.
0:10
And you can look at this colon and you can
0:13
compare it to the ascending colon and you
0:15
can see how much more enhancement there is.
0:17
So it's clearly inflamed.
0:19
We also notice that the whole bowel wall is
0:21
enhancing, so there's no sparing of the outer wall.
0:24
Importantly, it looks like the rectum is spared.
0:27
So, with rectal sparing like this, you're
0:30
immediately thinking this should not be
0:31
UC, unless they've had rectal steroids,
0:35
there's no reason why it would
0:36
spare the rectum to that degree.
0:38
And so we're thinking probably
0:40
Crohn's disease in this case.
0:42
We also see that the descending colon looks
0:44
relatively okay, but as we get up here, kind of
0:46
splenic flexure of the colon up into the
0:49
mid transverse, we can again see enhancement.
0:52
So that indicates that there's some sort of skip
0:54
lesion involving the sigmoid colon as well as
0:57
the splenic flexure of the colon with sparing
1:00
of this portion, at least, of the transverse, maybe some
1:03
more involvement here and then sparing of the cecum.
1:06
No small bowel disease interestingly.
1:08
So this would be Crohn's disease with skip
1:11
lesions, but isolated to the colon and not
1:15
ulcerative colitis, which is the important
1:17
differential that they're going to want to exclude.
1:20
Here you can see really nicely how
1:21
you have this lesion here, nothing here
1:25
and down here, and nothing here.
1:27
And so this is Crohn's disease with
1:30
colon involvement and skipped lesions.
Interactive Transcript
0:01
All right, here we have another case of
0:03
inflammatory bowel disease involving the colon.
0:06
In this case, what we see is clear
0:08
hyperenhancement in the sigmoid colon.
0:10
And you can look at this colon and you can
0:13
compare it to the ascending colon and you
0:15
can see how much more enhancement there is.
0:17
So it's clearly inflamed.
0:19
We also notice that the whole bowel wall is
0:21
enhancing, so there's no sparing of the outer wall.
0:24
Importantly, it looks like the rectum is spared.
0:27
So, with rectal sparing like this, you're
0:30
immediately thinking this should not be
0:31
UC, unless they've had rectal steroids,
0:35
there's no reason why it would
0:36
spare the rectum to that degree.
0:38
And so we're thinking probably
0:40
Crohn's disease in this case.
0:42
We also see that the descending colon looks
0:44
relatively okay, but as we get up here, kind of
0:46
splenic flexure of the colon up into the
0:49
mid transverse, we can again see enhancement.
0:52
So that indicates that there's some sort of skip
0:54
lesion involving the sigmoid colon as well as
0:57
the splenic flexure of the colon with sparing
1:00
of this portion, at least, of the transverse, maybe some
1:03
more involvement here and then sparing of the cecum.
1:06
No small bowel disease interestingly.
1:08
So this would be Crohn's disease with skip
1:11
lesions, but isolated to the colon and not
1:15
ulcerative colitis, which is the important
1:17
differential that they're going to want to exclude.
1:20
Here you can see really nicely how
1:21
you have this lesion here, nothing here
1:25
and down here, and nothing here.
1:27
And so this is Crohn's disease with
1:30
colon involvement and skipped lesions.
Report
Faculty
Benjamin Spilseth, MD, MBA, FSAR
Associate Professor of Radiology, Division Director of Abdominal Radiology
University of Minnesota
Tags
Small Bowel
Non-infectious Inflammatory
MRI
Large Bowel-Colon
Idiopathic
Gastrointestinal (GI)
Crohn’s Disease
Body
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