Magnetic resonance imaging in Crohn's disease - Colour illustrations

UvA-DARE (Digital Academic Repository)

Magnetic resonance imaging in Crohn's disease

Horsthuis, K.

Publication date

2008

Link to publication

Citation for published version (APA):

Horsthuis, K. (2008). Magnetic resonance imaging in Crohn's disease.

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Colour illustrations

Colour illustrations

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Chapter 8 Figure 1: 29-year old female patient with active CD.

a. Post-contrast T1-weighted transversal image with inflamed bowel loop (arrowheads)

b. Identical post-contrast T1-weighted transversal image with Gadolinium-map displayed as overlay. Concentrations in the actively inflamed bowel loop are as high as 0.5 mmol/l. c. Endoscopic view of the severely inflamed bowel of the

patient.

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Chapter 9 Figure 14: 56-year old woman with a permanent ileostomy due to Crohn’s disease with discharge

of pus and mucus rectally ascribed to her vast and complex perianal fistulous disease. Digital rectal examination was impossible to perform due to profound perianal pain. During an operation scheduled for excision of fistulas a large rectal tumor was revealed.

a. Axial T2-weighted image shows a large lesion isointense in comparison with the surrounding fat (solid arrows). Features differentiating between an abscess and a mucous tumor are amongst others the presence of a stalk (open arrow) and the streakiness of the structure seen on the fat saturated T2-weighted images (not shown). b. Microscopic specimen of the tumor after resection. HE coloring, 200 x enlarged. After microscopic evaluation the tumor turned out to be a moderately differentiated mucinous adenocarcinoma.

Colour illustrations

237

SI: signal intensity Type 1: no enhancement

Type 2: slow enhancement, maximum of the curve is reached after half of the scan Type 3: quick enhancement, followed by a signal plateau

Type 4: fast enhancement and quick wash-out

Type 5: quick enhancement followed by a slow constant enhancement Type 6: arterial enhancement (characterised by a quick

uptake and a very quick decay, followed by a slowly decaying plateau)

Type 7: unclassified enhancement including all the curves that cannot be classified as any of the above.

Chapter 11 Figure 1: Classification of TIC

Chapter 11 Figure 2: DCE-MRI findings in a 44-yr old male patient with a transsphincteric fistula

a. Axial oblique FS T2 weighted turbo spin-echo image with perianal fistulizing disease present

b. TIC shape type map with a ROI drawn around the pathology as identified on the fat saturated T2-weighted image. In the ROI many pixels with TIC type 2 are present, but pixels with TIC types 3 and 4 are also observed. c. ME map of the same slice. Maximum enhancement of the perianal fistula is higher than of the surrounding tissue.