http://repub.eur.nl/res/aut/30432/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/37639/ 2012-11-02T00:00:00Z Visualization of the small bowel is a clinical challenge due to its length, motility, shape, and central location distal to the stomach and proximal to the coecum. During the last decade, several new techniques have been introduced for visualizing the small bowel. Radiologists and clinicians are now faced with a dilemma in deciding which technique to use in two common groups of adult patients: those with known or suspected Crohn’s disease, and those with obscure gastrointestinal bleeding. This decision is primarily based on the accuracy, burden, and patient preference of each technique. In patients with suspected Crohn’s disease, diagnosing the disease and establishing the location, extent, and severity of the disease is essential. Symptoms of Crohn’s disease can sometimes overlap those of other common gastrointestinal problems, such as irritable bowel syndrome (IBS), celiac disease, and other gastrointestinal abnormalities. Crohn’s disease is characterized as a chronic, relapsing, and remitting inflammatory bowel disease (IBD), which can start at an early age and may require lifelong surveillance. In the last few decades the incidence of Crohn’s disease has continued to increase worldwide, and the prevalence and incidence are the same in Europe and the United States. A north-south gradient and lower incidence of Crohn’s disease is present in Asian and African people. Crohn’s disease has a predilection for the terminal ileum; the disease localizes to the small bowel in 70% of patients, but it can also occur in any other part of the gastrointestinal tract. The inflammation is characterized by patchy, transmural, granulomatous lesions, which can cause a range of complications, such as small bowel stenosis, fistulas, and abscesses. In addition, colon involvement increases the risk of developing colorectal cancer. http://repub.eur.nl/res/pub/33996/ 2011-11-25T00:00:00Z New modalities are available to visualize the small bowel in patients with Crohn's disease (CD). The aim of this study was to compare the diagnostic yield of magnetic resonance enteroclysis (MRE) and capsule endoscopy (CE) to balloon-assisted enteroscopy (BAE) in patients with suspected or established CD of the small bowel. Consecutive, consenting patients first underwent MRE followed by CE and BAE. Patients with high-grade stenosis at MRE did not undergo CE. Reference standard for small bowel CD activity was a combination of BAE and an expert panel consensus diagnosis. Analysis included 38 patients, 27 (71%) females, mean age 36 (20-74) years, with suspected (n = 20) or established (n = 18) small bowel CD: 16 (42%) were diagnosed with active CD, and 13 (34%) by MRE with suspected high-grade stenosis, who consequently did not undergo CE. The reference standard defined high-grade stenosis in 10 (26%) patients. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value of MRE and CE for small bowel CD activity were 73 and 57%, 90 and 89%, 88 and 67%, and 78 and 84%, respectively. CE was complicated by capsule retention in one patient. MRE has a higher sensitivity and PPV than CE in small bowel CD. The use of CE is considerably limited by the high prevalence of stenotic lesions in these patients. http://repub.eur.nl/res/pub/24306/ 2009-07-01T00:00:00Z Purpose: This study aimed to determine the reliability of magnetic resonance imaging (MRI) without luminal contrast medium versus MR enteroclysis for evaluating small bowel pathology, to compare MRI and MRE findings per observer, and to compare these findings with those of an expert reader in order to determine the influence of luminal contrast medium on morphological evaluations. Conclusion: The use of luminal contrast medium bowel improves reliability for measuring bowel wall thickness and for the diagnosis and grading of obstruction when evaluating the small bowel. http://repub.eur.nl/res/pub/29801/ 2008-07-01T00:00:00Z Objective: MR enteroclysis has become an important tool to visualize the complete small bowel wall and extramural structures. In many centers, this technique is rapidly becoming the first-line technique for small bowel visualization. MR enteroclysis yields a diagnosis of thickened jejunal loops in some patients. In this paper, we describe an MR enteroclysis protocol and review the literature on jejunum abnormalities with several sample cases. Conclusion: Jejunum abnormalities are not uncommon. These abnormalities can be self-limiting, but some patients suffer from infectious and other pathologic conditions of the small bowel necessitating intervention.