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Structured magnetic resonance imaging and endoanal ultrasound anal fistulas reporting template(SMART):An interdisciplinary Delphi consensus

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World Journal of Gastrointestinal Surgery 2024年第10期16卷 3288-3300页

作者： Iwona Sudoł-Szopińska Pankaj Garg Anders Mellgren Antonino Spinelli Stephanie Breukink Francesca Iacobellis Małgorzata Kołodziejczak Przemysław Ciesielski christian jenssen SMART Collaborative Group Giulio Aniello Santoro Department of Radiology National Institute of GeriatricsRheumatology and RehabilitationWarsaw 02-637Poland Department of Colorectal Surgery Garg Fistula Research InstitutePanchkula 134113HaryanaIndia Department of Surgical Oncology King Faisal Specialist Hospital&Research CenterRiyadh 11211Saudi Arabia Department of Biomedical Sciences Humanitas UniversityPieve Emanuele-MilanItaly IRCCS Humanitas Research Hospital Rozzano-MilanItaly Department of Surgery Maastricht and NUTRIM Institute of Nutrition and Translational Research in Metabolism GROW-Research Institute for Oncology and Reproductionthe Netherlands Department of General and Emergency Radiology A.Cardarelli HospitalNaples 80131CampaniaItaly Warsaw Proctology Center St.Elizabeth HospitalWarsaw 02-616Poland Department of Internal Medicine Hospital Märkisch OderlandStrausberg 15344BrandenburgGermany Brandenburg Institute for Clinical Ultrasound Neuruppin 16186BrandenburgGermany Third Referral Pelvic Floor Center Division of Surgery 2AULSS n.2 Marca TrevigianaDISCOG University of PaduaTrevisoItaly 不详

BACKGROUND There is still considerable heterogeneity regarding which features of cryptoglandular anal fistula on magnetic resonance imaging(MRI)and endoanal ultrasound(EAUS)are relevant to surgical *** a con-sequence,the quality and completeness of the report are highly dependent on the training and experience of the *** To develop a structured MRI and EAUS template(SMART)reporting the minimum dataset of information for the treatment of anal *** This modified Delphi survey based on the RAND-UCLA appropriateness for consensus-building was conducted between May and August *** hundred and fifty-one articles selected from a systematic review of the lite-rature formed the database to generate the evidence-based statements for the Delphi *** questions were anonymously voted by an interdisciplinary multidisciplinary group for a maximum of three iterative *** degree of agreement was scored on a numeric 0–10 *** consensus was defined as a score≥8 for≥80%of the *** Eleven scientific societies(3 radiological and 8 surgical)endorsed the *** three rounds of voting,the experts(69 colorectal surgeons,23 radiologists,2 anatomists,and 1 gastroenterologist)achieved consensus for 12 of 14 statements(85.7%).Based on the results of the Delphi process,the six following features of anal fistulas were included in the SMART:Primary tract,secondary extension,internal opening,presence of collection,coexisting le-sions,and sphincters *** A structured template,SMART,was developed to standardize imaging reporting of fistula-in-ano in a simple,systematic,time-efficient way,providing the minimum dataset of information and visual diagram useful to refer-ring physicians.

关键词： Anal fistulas Fistula-in-ano Template Reporting Magnetic resonance imaging Endoanal ultrasound

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Diagnostic endoscopic ultrasonography:Assessment of safety and prevention of complications

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World Journal of Gastroenterology 2012年第34期18卷 4659-4676页

作者： christian jenssen Maria Victoria Alvarez-Sánchez Bertrand Napoléon Siegbert Faiss Department of Internal Medicine Krankenhaus M rkisch-Oderland GmbHD15344 StrausbergGermany Department of Gastroenterology and Hepatology Hopital Privé Jean MermozF69008 LyonFrance Department of Gastroenterology and Hepatology Asklepios Klinik BarmbekD22291 HamburgGermany

Endoscopic ultrasonography (EUS) has gained wide acceptance as an important, minimally invasive diagnostic tool in gastroenterology, pulmonology, visceral surgery and oncology. This review focuses on data regarding risks and complications of non-interventional diagnostic EUS and EUS-guided fine-needle biopsy (EUS-FNB). Measures to improve the safety of EUS und EUS-FNB will be discussed. Due to the specific mechanical properties of echoendoscopes in EUS, there is a low but noteworthy risk of perforation. To minimize this risk, endoscopists should be familiar with the specific features of their equipment and their patients' specific anatomical situations (e.g., tumor stenosis, diverticula). Most diagnostic EUS complications occur during EUS-FNB. Pain, acute pancreatitis, infection and bleeding are the primary adverse effects, occurring in 1% to 2% ofpatients. Only a few cases of needle tract seeding and peritoneal dissemination have been reported. The mortality associated with EUS and EUS-FNB is 0.02%. The risks associated with EUS-FNB are affected by endoscopist experience and target lesion. EUS-FNB of cystic lesions is associated with an increased risk of infection and hemorrhage. Peri-interventional antibiotics are recommended to prevent cyst infection. Adequate education and training, as well consideration of contraindications, are essential to minimize the risks of EUS and EUS-FNB. Restricting EUS-FNB only to patients in whom the cytopathological results may be expected to change the course of management is the best way of reducing the number of complications.

关键词： Endoscopic ultrasonography Endoscopic ul-trasonography-guided fine-needle biopsy Complications Contraindications Risk Safety Perforation Bleeding Infection Acute pancreatitis

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Serous pancreatic neoplasia, data and review

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World Journal of Gastroenterology 2017年第30期23卷 5567-5578页

作者： Christoph F Dietrich Yi Dong christian jenssen Valentina Ciaravino Michael Hocke Wen-Ping Wang Eike Burmester Kathleen Moeller Nathan SS Atkinson Paola Capelli Mirko D’Onofrio Medizinische Klinik 2 Caritas-Krankenhaus Bad Mergentheim Ultrasound Department First Affiliated Hospital of Zhengzhou University Department of Ultrasound Zhongshan HospitalFudan University Department of Internal Medicine Krankenhaus Markisch Oderland Strausberg/Wriezen Department of Radiology G.B Rossi University HospitalUniversity of Verona Department of Internal Medicine 2 Helios Hospital Meiningen GmbH Department of Internal Medicine I Sana Klinikum Lichtenberg Translational Gastroenterology Unit Oxford University Hospitals NHS Foundation Trust Department of Pathology G.B Rossi University HospitalUniversity of Verona Department of Radiology GB Rossi University HospitalUniversity of Verona

AIM To describe the imaging features of serous neoplasms of the pancreas using ultrasound, endoscopic ultrasound, computed tomography and magnetic resonance *** This multicenter international collaboration enhances a literature review to date, reporting features of 287 histologically confirmed cases of serous pancreatic cystic neoplasms(SPN). RESULTS Female predominance is seen with most SPN presenting asymptomatically in the 5th through 7th decade. Mean lesion size was 38.7 mm, 98% were single, 44.2% cystic, 46% mixed cystic and solid, and 94% hypoechoic on B-mode ultrasound. Vascular patterns and contrast-enhancement profiles are described as hypervascular and *** The described ultrasound features can aid differentiation of SPN from other neoplastic lesions under most circumstances.

关键词： Guideline Cancer Ultrasound Endoscopic ultrasound Elastography

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New ultrasound techniques for lymph node evaluation

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World Journal of Gastroenterology 2013年第30期19卷 4850-4860页

作者： Xin-Wu Cui christian jenssen Adrian Saftoiu Andre Ignee Christoph F Dietrich Med.Klinik 2 Caritas-Krankenhaus97980 Bad MergentheimGermany Klinik für Innere Medizin Krankenhaus M rkisch Oderland15334 StrausbergGermany Department of Gastroenterology Research Center of Gastroenterology and HepatologyUniversity of Medicine and Pharmacy Craiova200349 CraiovaRomania

Conventional ultrasound(US)is the recommended imaging method for lymph node(LN)diseases with the advantages of high resolution,real time evaluation and relative low *** indications of transcutaneous ultrasound and endoscopic ultrasound include the detection and characterization of lymph nodes and the guidance for LN *** advances in US technology,such as contrast enhanced ultrasound(CEUS),contrast enhanced endoscopic ultrasound(CE-EUS),and real time elastography show potential to improve the accuracy of US for the differential diagnosis of benign and malignant lymph *** addition,CEUS and CE-EUS have been also used for the guidance of fine needle aspiration and assessment of treatment *** to size criteria,CEUS could also be used to evaluate response of tumor angiogenesis to anti-angiogenic *** this paper we review current literature regarding evaluation of lymphadenopathy by new and innovative US techniques.

关键词： Lymph nodes Ultrasound Endoscopic ultrasound Lymph node metastasis Lymphoma

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Fortuitously discovered liver lesions

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World Journal of Gastroenterology 2013年第21期19卷 3173-3188页

作者： Christoph F Dietrich Malay Sharma Robert N Gibson Schreiber-Dietrich christian jenssen Department of Internal Medicine Caritas-Krankenhaus Bad Mergentheim97980 Bad MergentheimGermany Department of Gastroenterology Jaswantrai Speciality HospitalOpposite Sports StadiumMeerut UP 250001India Department of Radiology University of MelbourneRoyal Melbourne HospitalVictoria 3050Australia Dagmar Department of Pediatrics Asklepiosklinik St. AugustinAbt. Neonatologie und P diatrische Intensivmedizin52757 AugustinGermany Klinik für Innere Medizin Krankenhaus Mrkisch Oderland15334 StrausbergGermany

The fortuitously discovered liver lesion is a common problem. Consensus might be expected in terms of its work-up, and yet there is none. This stems in part from the fact that there is no preventive campaign involving the early detection of liver tumors other than for patients with known liver cirrhosis and oncological patients. The work-up (detection and differential diagnosis) of liver tumors comprises theoretical considerations, history, physical examination, laboratory tests, standard ultrasound, Doppler ultrasound techniques, contrastenhanced ultrasound (CEUS), computed tomography and magnetic resonance imaging, as well as imageguided biopsy. CEUS techniques have proved to be the most pertinent method; these techniques became part of the clinical routine about 10 years ago in Europe and Asia and are used for a variety of indications in daily clinical practice. CEUS is in many cases the first and also decisive technical intervention for detecting and characterizing liver tumors. This development is reflected in many CEUS guidelines, e.g. , in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines 2004, 2008 and 2012 as well as the recently published World Federation for Ultrasound in Medicine and Biology-EFSUMB guidelines 2012. This article sets out considerations for making a structured work-up of incidental liver tumors feasible.

关键词： Contrast-enhanced ultrasound Hepatocellular carcinoma Hemangioma Focal nodular hyperplasia Metastasis Ultrasonography Recommendations Guidelines

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A review of ecological impacts of global climate change on persistent organic pollutant and mercury pathways and exposures in arctic marine ecosystems

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Current Zoology 2015年第4期61卷 617-628页

作者： Melissa A. MCKINNEY Sara PEDRO Rune DIETZ christian SONNE Aaron T. FISK Denis ROY Bjorn M. jenssen Robert J. LETCHER Department of Natural Resources and the Environment University of Connecticut Storrs CT 06269 USA Center for Environmental Sciences and Engineering University of Connecticut Storrs CT 06269 USA Department of Bioscience Arctic Research Centre Aarhus University Roskilde DK-4000 Denmark Great Lakes Institute for Environmental Research University of Windsor Windsor ON N9B 3P4 Canada Department of Biology Norwegian University of Science and Technology Trondheim NO-7491 Norway Wildlife and Landscape Science Directorate Science and Technology Branch Environment Canada National Wildlife Research Centre Carleton University Ottawa ON K1A 0H3 Canada

Bioaccumulative and biomagnifying contaminants, such as persistent organic pollutants （POPs） and mercury （Hg）, have for decades been recognized as a health concern in arctic marine biota. In recent years, global climate change （GCC） and related loss of arctic sea ice have been observed to be driving substantial change in arctic ecosystems. This review summarizes findings documenting empirical links between GCC-induced ecological changes and alterations in POP and Hg exposures and pathways in arctic marine ecosystems. Most of the studies have reported changes in POP or Hg concentrations in tissue in relation to GCC-induced changes in species trophic interactions. These studies have typically focused on the role of changes in abun- dance, habitat range or accessibility of prey species, particularly in relation to sea ice changes. Yet, the ecological change that re- suited in contaminant trend changes has often been unclear or assumed. Other studies have successfully used chemical tracers, such as stable nitrogen and carbon isotope ratios and fatty acid signatures to link such ecological changes to contaminant level variations or trends. Lower sea ice linked-diet changes/variation were associated with higher contaminant levels in some popula- tions of polar bears, ringed seals, and thick-billed murres, but the influence of changing trophic interactions on POP levels and trends varied widely in both magnitude and direction. We suggest that future research in this new area of GCC-linked ecotox- icology should focus on routine analysis of ancillary ecological metrics with POP and Hg studies, simultaneous consideration of the multiple mechanisms by which GCC and contaminant interactions can occur, and targeted research on changing exposures and toxicological effects in species known to be sensitive to both GCC and contaminants [Current Zoology 61 （4）： 617-628, 2015].

关键词： Climate change Ecological change Contaminants Trends Arctic Marine ecosystems

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