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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
So here's another pattern that we sometimes see when
0:03
we have segmental neural hyperenhancement, and you've
0:06
probably all seen this before when you have this inner wall
0:09
that's more enhancing than the rest of the wall.
0:13
So in that prior case, it was kind of a diffuse
0:15
hyperenhancement throughout the bowel wall.
0:20
Now, some people call this mucosal hyperenhancement,
0:23
but I think that that's probably not the
0:25
best word or way to describe this, and that's
0:29
what the expert opinion is saying as well.
0:32
Instead of using mucosal hyperenhancement, the
0:34
preferred terminology is calling it inner wall
0:36
hyperenhancement or a bilaminar pattern of
0:39
hyperenhancement, and that's because the mucosa in
0:42
these cases is often disrupted and sloughed, and so,
0:45
the part that you would think would be mucosa
0:48
on that inner wall may be totally absent.
0:50
And so when you say mucosal enhancement,
0:52
it's somewhat misleading
0:53
because the mucosa may be totally gone.
0:55
So using the term inner wall hyperenhancement is preferred.
0:57
24 00:00:59,925 --> 00:01:02,635 Well, this is often seen with Crohn's disease, and it's,
1:02
it's a fairly typical and expected enhancement pattern.
1:06
It's not an entirely specific pattern either.
1:09
Other things can cause this.
1:11
It can be due to some
1:13
fat in the bowel that's inflamed or
1:15
edema in the bowel that's inflamed.
1:17
So it's not a specific finding for Crohn's disease.
1:21
However, it is an important thing
1:23
to recognize and to talk about.
1:25
When you see this on an early phase,
1:27
it does indicate there's some degree
1:29
of active inflammation, most likely.
1:32
So that's it.
1:33
That's one pattern of enhancement.
1:34
And then we'll look at a couple other
1:35
patterns on the following cases.
Interactive Transcript
0:01
So here's another pattern that we sometimes see when
0:03
we have segmental neural hyperenhancement, and you've
0:06
probably all seen this before when you have this inner wall
0:09
that's more enhancing than the rest of the wall.
0:13
So in that prior case, it was kind of a diffuse
0:15
hyperenhancement throughout the bowel wall.
0:20
Now, some people call this mucosal hyperenhancement,
0:23
but I think that that's probably not the
0:25
best word or way to describe this, and that's
0:29
what the expert opinion is saying as well.
0:32
Instead of using mucosal hyperenhancement, the
0:34
preferred terminology is calling it inner wall
0:36
hyperenhancement or a bilaminar pattern of
0:39
hyperenhancement, and that's because the mucosa in
0:42
these cases is often disrupted and sloughed, and so,
0:45
the part that you would think would be mucosa
0:48
on that inner wall may be totally absent.
0:50
And so when you say mucosal enhancement,
0:52
it's somewhat misleading
0:53
because the mucosa may be totally gone.
0:55
So using the term inner wall hyperenhancement is preferred.
0:57
24 00:00:59,925 --> 00:01:02,635 Well, this is often seen with Crohn's disease, and it's,
1:02
it's a fairly typical and expected enhancement pattern.
1:06
It's not an entirely specific pattern either.
1:09
Other things can cause this.
1:11
It can be due to some
1:13
fat in the bowel that's inflamed or
1:15
edema in the bowel that's inflamed.
1:17
So it's not a specific finding for Crohn's disease.
1:21
However, it is an important thing
1:23
to recognize and to talk about.
1:25
When you see this on an early phase,
1:27
it does indicate there's some degree
1:29
of active inflammation, most likely.
1:32
So that's it.
1:33
That's one pattern of enhancement.
1:34
And then we'll look at a couple other
1:35
patterns on the following cases.
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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