methylcellulose and Intestinal-Neoplasms

To determine the value of MR enteroclysis (MRE) in the localization and characterization of primary carcinoid tumors of the small bowel and to describe typical imaging features.. Twenty patients with suspicion of primary small bowel carcinoid tumors (pCT) were recruited to undergo MRE following nasojejunal intubation and small bowel filling with 2.5 l of 0.5% methylcellulose solution under MR fluoroscopic guidance. MRE was performed on a 1.5 T MR scanner including T2w SSFSE, SSFP and contrast enhanced T1w GRE sequences with fat saturation. Fifteen patients, who subsequently had surgery for resection of their pCT, were retrospectively included in the study. All MRE were analyzed as for the presence, location, number, size, multiplicity and morphologic appearance of the pCT by two board certified radiologists in consensus. The conspicuity of the tumors was rated for each sequence type separately, according to a 4-point rating scale. Signal intensity measurements were performed in tumor and muscle. The presence of desmoplastic reaction, vascular involvement and lymph node metastases was also analyzed.. pCT were correctly identified and localized in 14/15 patients. Due to their hyperenhancement tumors was best detected on contrast-enhanced T1w fat saturated GRE sequences. SSFSE was clearly inferior with the tumors being either hyperintense or isointense to muscle. pCT appeared as nodular intraluminal masses in 40% of the cases, as focal wall thickening in 33.3% and in 20% with both. Mean size was 25 (7-46 mm) with a tendency to smaller size for ileal tumors. MRE failed to depict superficial micronodular peritoneal spread in one patient. Desmoplastic reaction was observed in 73.3% of the cases with mesenteric masses exhibiting lower signal than the pCT due to fibrotic changes.. MRE is a valuable method for the detection and localization of primary carcinoid tumors, provided that appropriate bowel distension is achieved. Various characteristic morphologic features could be identified which may contribute to characterize pCT and their loco-regional metastases.

Topics: Adult; Aged; Aged, 80 and over; Carcinoid Tumor; Contrast Media; Disease Progression; Female; Fluoroscopy; Gadolinium DTPA; Humans; Ileal Neoplasms; Image Processing, Computer-Assisted; Intestinal Neoplasms; Intestine, Small; Intubation, Gastrointestinal; Jejunal Neoplasms; Liver Neoplasms; Lymphatic Metastasis; Magnetic Resonance Imaging; Male; Methylcellulose; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Neoplasms, Multiple Primary; Prognosis; Retrospective Studies; Tomography, X-Ray Computed

The aim of our study was to evaluate the reliability of MDCT-enteroclysis (MDCT-E), an emerging technique of small bowel examination that combines the advantages of MDCT examination of the abdomen and the enteral volume challenge of enteroclysis, in evaluation of small bowel neoplasms. In our institutions, MDCT-E was used to study 456 patients (age range 21-84 years, mean 53 years) admitted for suspicion of small bowel disease. All examinations were done on multichannel CT units, 129 on a 16-slice scanner and 327 on a four-slice scanner. Post-processing and multiplanar reformatting and interpretation were performed on dedicated workstations. After adequate gastrointestinal preparation and naso-enteric intubation, small bowel was distended by methylcellulose infused by a peristaltic pump. One volumetric MDCT acquisition was obtained after 120-130 ml of intravenous contrast medium. Multiplanar reformatting was based on the image reconstruction parameters from 3 to 4 mm. Forty-five small bowel neoplasms were found; in the remaining cases, 223 Crohn's diseases and 149 other abnormalities were detected. All findings were confirmed by surgery, endoscopy or clinical follow-up. In our experience, MDCT-E with neutral enteral and IV contrast seems to be a reliable method in the diagnosis of small bowel neoplasms.

Topics: Adult; Aged; Aged, 80 and over; Barium Sulfate; Contrast Media; Female; Humans; Infusions, Intravenous; Intestinal Neoplasms; Intestine, Small; Male; Methylcellulose; Middle Aged; Radiography, Abdominal; Tomography, X-Ray Computed

Aim of the study was to compare the visualisation of small bowel tumours particularly lymphoma of the small bowel by enteroclysma, computed tomography (CT) and computed tomography following enteroclysma.. We examined 97 examinations in 63 patients. Non Hodgkin's Lymphoma was the primary malignancy in 44 patients, metastasis of different malignancies in 8 patients, primary malignancies of the small intestine in 5 patients, mesenteric tumours in 4 patients and postoperative stricture in another 2 patients. CT following enteroclysma (CT Sellink) was performed as helical CT in 55 patients and as incremental CT in 42 patients. Examinations were evaluated by two radiologists. Evaluation criteria were small bowel distension, perceptibility of details and topographic correlation.. Manifestations of lymphoma were found in 32 patients, infiltration of bowel wall in 12 patients. In three patients metastases of melanoma were found. In three patients the suspicion for small bowel tumours was not verified in CT Sellink. The perceptibility of details was evaluated as ameliorated in 45.5% of examinations over all.. CT Sellink offers remarkable advantages in the diagnosis of small bowel tumours compared with enteroclysma and "conventional" computed tomography under intra-venous and oral contrast media. CT Sellink was feasible over a time of 7 years now in clinical praxis. This examination represents an optimized standard in small intestine examination.

Topics: Adult; Aged; Contrast Media; Female; Humans; Image Processing, Computer-Assisted; Intestinal Neoplasms; Intestine, Small; Iohexol; Lymphoma, Non-Hodgkin; Male; Methylcellulose; Middle Aged; Radiographic Image Enhancement; Sensitivity and Specificity; Tomography, X-Ray Computed

The aim of this study was to evaluate the accuracy of enteroclysis in the diagnosis of Crohn's disease of the small bowel in a group of consecutive patients. From January 1992 to December 1995, 165 patients with suspected Crohn's disease of the small bowel presented to our institution for enteroclysis. In 14 patients up to three enteroclysis exams were performed. Most patients (78%) underwent colonoscopy and retrograde ileoscopy. In the remaining patients clinical follow-up was used as gold standard. In 79 patients no radiographic abnormalities were found. Sixty-one patients (40 men and 21 women; mean age 34.2 years) had a radiological diagnosis of Crohn's disease. This involved the terminal ileum in 39 patients (64%) either alone (n = 25) or in association with the pelvic ileum (n = 14). In 12 of these patients retrograde ileoscopy was not feasible. Twenty-one patients underwent surgery. In 4 patients pathology revealed diseases other than Crohn's. These patients had all ileocecal diseases (tuberculosis = 2; non-Hodgkin's lymphoma = 1; adenocarcinoma = 1). One false-negative result was observed. Overall, enteroclysis showed a sensitivity of 98.2% and a positive predictive value of 93.4%. Enteroclysis is a sensitive technique in evaluating both the extent and the severity of small bowel involvement in Crohn's disease, although the overlap of radiographic findings may hamper its accuracy when the disease is confined to the ileocecal area.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Barium Sulfate; Child; Contrast Media; Crohn Disease; Diagnostic Errors; Enema; Female; Humans; Intestinal Neoplasms; Intestine, Small; Male; Methylcellulose; Middle Aged; Predictive Value of Tests; Radiography; Retrospective Studies; Sensitivity and Specificity

The diagnostic yield of enteroclysis was retrospectively evaluated for patients with obscure bleeding from the gastrointestinal tract.. A total of 128 patients with obscure gastrointestinal bleeding were referred to our department for enteroclysis between 1988 and 1993. The original radiologic reports were reviewed to determine the radiographic findings in these patients. The radiographic findings then were correlated with medical, surgical, and pathologic findings.. Thirty-two patients had lesions found at enteroclysis. Nineteen of those patients had confirmation of the radiographic diagnosis, primarily by pathologic examination of the surgical specimen. Five other patients were found at surgery to have had false-positive diagnoses at enteroclysis. Eight patients ceased to bleed without pathologic corroboration, but their clinical presentation and course supported the radiographic diagnosis. Thus, 27 (21%) of the 128 patients had confirmed or highly probable lesions seen at enteroclysis as the cause of obscure gastrointestinal bleeding. Seventeen patients (13%) had tumors involving the small bowel, and three (2%) had arteriovenous malformations in the jejunum.. This study corroborates earlier reports that enteroclysis is a useful diagnostic test for examining the small intestine in patients with obscure gastrointestinal bleeding.

Topics: Adult; Aged; Aged, 80 and over; Barium Sulfate; Enema; Female; Gastrointestinal Hemorrhage; Humans; Intestinal Neoplasms; Intestine, Small; Male; Methylcellulose; Middle Aged; Radiography; Retrospective Studies

In certain diseases originating from the small intestine the peroral application of contrast medium can complete with enteroclysis. The use of methylcellulose MH 1000 proved to be a good compromise between viscosity ans stability of mucosal coating. It allowed good image quality in all segments of the small bowel particularly in the distal ileum. Therefore, this method is clearly indicated in Crohn's disease. Good results were also obtained in delineating tumours, radiation enteritis and ischaemic enteritis. With few patients exhibiting reduced small bowel mobility and/or who are incapable of drinking adequate volumes of contrast medium the results of the oral method are rather unfavourable.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Barium Sulfate; Crohn Disease; Drug Evaluation; Humans; Intestinal Neoplasms; Intestine, Small; Methylcellulose; Middle Aged; Radiographic Image Enhancement; Solutions; Viscosity

Topics: Barium Sulfate; Child; Child, Preschool; Contrast Media; Crohn Disease; Humans; Hyperplasia; Intestinal Neoplasms; Intestine, Small; Lymph Nodes; Meckel Diverticulum; Methylcellulose; Radiography

The value of double contrast small bowel enema via duodenal intubation using barium sulphate and methylcellulose as contrast media was assessed in 250 patients. In cases of small bowel obstruction it represented the first-line investigation after a plain abdominal film. It was performed electively in patients of painful bowel syndrome, in cases of malabsorption, in cases of endoscopically or radiologically diagnosed colitis and in patients with Crohn's disease. On the basis of our results we believe double contrast small bowel enema to be the most reliable investigation in the localization and identification of small bowel lesions.

Topics: Barium Sulfate; Contrast Media; Crohn Disease; Enema; Humans; Intestinal Neoplasms; Intestinal Obstruction; Intestine, Small; Intubation, Gastrointestinal; Malabsorption Syndromes; Methylcellulose; Radiography

A modification of the small-bowel enema with barium and methylcellulose is described and findings in 300 consecutive examinations compared with the clinical diagnoses. The radiograph was positive in 37% of cases and the clinical examination in 29%. Diseases and abnormalities of the small bowel, including motility disorders, can be diagnosed with high sensitivity and specificity using this technique.

Topics: Adenocarcinoma; Adult; Barium Sulfate; Celiac Disease; Crohn Disease; Evaluation Studies as Topic; Gastrointestinal Motility; Humans; Intestinal Diseases; Intestinal Neoplasms; Intestinal Obstruction; Intestine, Small; Methods; Methylcellulose; Radiography