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Magnetic resonance imaging:Is there a role in clinical management for acute ischemic colitis?

World Journal of Gastroenterology 2013年第8期19卷 1256-1263页

作者： Maria Antonietta Mazzei Susanna Guerrini Nevada Cioffi Squitieri Giusi Imbriaco raffaele chieca Serenella Civitelli Vinno Savelli Francesco Giuseppe Mazzei Luca Volterrani Department of Human Pathology and Oncology Section of Radiological SciencesUniversity of Siena53100 SienaItaly Oncologic Department UOC Gastroenterology and Digestive EndoscopyAzienda Ospedaliera Universitaria Senese53100 SienaItaly Division of Surgery Azienda Ospedaliera Universitaria SeneseUniversity of Siena53100 SienaItaly Department of Surgery and Bioengineering Section of SurgeryUniversity of Siena53100 SienaItaly Department of Diagnostic Imaging Azienda Ospedaliera Universitaria Senese53100 SienaItaly

AIM:To validate the utility of magnetic resonance imaging(MRI) for the clinical management of acute ischemic colitis(IC).METHODS:This is a magnetic resonance(MR) prospective evaluation of 7 patients who were proved to have acute IC on the basis of clinical,endoscopic and computed tomography(CT) findings and who were imaged in our institution between February 2011 and July *** mean age of the patients was 72.28 *** CTs were obtained using a 64-detector row configuration for all patients with un-enhanced and contrast-enhanced scans,in the late arterial phase(start delay 45-50 s) and in the portal venous phase(start delay 70-80 s).The MR examinations were performed using a 1.5T superconducting magnet,using Fast Imaging Employing Steady State Acquisition and T2-weighted fast-recovery fast-spin echo sequences in axial and coronal *** and MRI examinations were analysed for the presence of colonic abnormalities and associated ***:Segmental involvement was seen in 6 patients(85.71%),with a mean length of involvement of 412 mm(range 145.5-1000 mm).Wall thickness varied between 6 mm and 17.5 mm(mean 10.52 mm) upon CT examinations and from 5 to 15 mm(mean 8.8 mm) upon MR *** MRI appearance of the colonic wall varied over the time:TypeⅠappearance with a 3 layer sandwich sign was seen in 5 out of 12 examinations(41.66%),patients underwent MR within a mean of 36 h(ranging from 1 to 54 h) after the CT *** Ⅱ and Ⅲ appearance with a 2 layer sign,was seen in 4 examinations(33.33%),patients underwent MR within a mean of 420.5 h(ranging from 121 to 720 h) after the CT *** the remaining three MRI examinations,performed within a mean of 410 h(ranging from 99.5 to 720 h) the colonic wall appeared ***:MRI,only using precontrast images,may be used as a substitute for invasive procedures in diagnosis and follow-up of acute IC.

关键词： Ischemic colitis Magnetic resonance imaging Medical management Colon Computed tomography

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