ENTEROCOLITIDES CAN YOU TELL THEM APART ON MDCT? Richard M. Gore, MD North Shore University Medical Center University of Chicago Evanston, Illinois
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1 ENTEROCOLITIDES CAN YOU TELL THEM APART ON MDCT? Richard M. Gore, MD North Shore University Medical Center University of Chicago Evanston, Illinois SCBT/MR 2010 San Diego, California March 8, :40-14:00 14:00
2 ENTEROCOLITIS WORLD WIDE TRAVEL CROHNS DISEASE ANTIBIOTICS AIDS CHEMOTHERAPY TRANSPLANTATION AGING POPULATION HEPATITIS C
3 RADIOLOGIC EVALUATION US MR SCINTIGRAPHY BE KUB CT
4 USE OF PLAIN FILM TO DETERMINE CT TECHNIQUE BIG DISTENDED LOOPS: BO vs ILEUS vs TOXIC MEGACOLON --- IV CONTRAST ONLY GASLESS ABDOMEN: ISCHEMIA, BO, FULMINANT COLITIS WITH FLUID IV CONTRAST ONLY CROHN S S DISEASE COMPLICATIONS OR NORMAL, NON SPECIFIC GAS PATTERN: ORAL AND IV CONTRAST CROHN S S DISEASE ACTIVITY: IV CONTRAST AND NEUTRAL CONTRAST (VOLUMEN)
5 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
6 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS HOMOGENEOUS HETEROGENEOUS MIXED
7 LENGTH OF INVOLVEMENT: FOCAL < 5 cm Adenocarcinoma
8 LENGTH OF INVOLVEMENT: FOCAL < cm Diverticulitis Crohn s s disease Ischemia
9 LENGTH OF INVOLVEMENT: SEGMENTAL < cm Ischemia Submucosal hemorrhage Radiation Infection Crohn s s disease Lymphoma
10 LENGTH OF INVOLVEMENT: DIFFUSE Infectious enterocolitis Ulcerative colitis Edema from low protein and cirrhosis Systemic lupus erythematosis
11 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
12 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
13 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
14 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
15 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
16 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
17 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
18 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
19 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
20 CT FEATURES MURAL ENHANCEMENT PATTERN LENGTH OF INVOLVEMENT DEGREE OF MURAL THICKENING PATENCY OF MESENTERIC VESSELS MESENTERIC CHANGES LUMEN CONTENTS
21 WHITE GRAY TARGET WATER TARGET FAT GAS
22 TYPE 1: WHITE NORMAL ENHANCEMENT IN NORMAL BOWEL
23 TYPE 1: WHITE VASODILATION WITH HYPEREMIA ACUTE IBD INJURY TO INTRA- MURAL VESSELS CONTRAST LEAK: SHOCK BOWEL, RE- PERFUSION AFTER ISCHEMIA HEMORRHAGE
24 TYPE 2: GRAY HOMOGENEOUS ENHANCEMENT ~SK MUSCLE CHRONIC CROHN S DISEASE ISCHEMIA NEOPLASM
25 TYPE 3: TARGET-WATER Portal hypertension Pseudomembranous Typhlitis Infections AIDS Acute UC Acute CD Ischemia
26 TYPE 4: TARGET -FAT CHRONIC UC CHRONIC CD OBESE PTs CHEMOTHERAPY
27 TYPE 5-5 PNEUMATOSIS ISCHEMIA INFECTION TRAUMA BENIGN CAUSES CONNECTIVE TISSUE IBD OBSTRUCTION COPD
28 NL BOWEL IBD HYPEREMIA SHOCK BOWEL REPERFUSED ISCHEMIA Thick- venous WHITE Thin- arterial
29 CHRONIC CD NEOPLASM ISCHEMIA (Arterial) GRAY
30 ACUTE IBD INFECTIONS ISCHEMIA RADIATION PORTAL HTN TYPHLITIS TARGET WATER PSEUDO COLITIS
31 CHRONIC UC CHRONIC CD OBESE PT CHEMO TARGET FAT
32 INFECTION INFARCTION TRAUMA BENIGN CAUSES GAS
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