Diffusion Weighted
Imaging of the
Gastrointestinal Tract
Techniques and Clinical
Applications
Sofia Gourtsoyianni
Nikolaos Papanikolaou
Editors
123
Diffusion Weighted Imaging
of the Gastrointestinal Tract
Sofia Gourtsoyianni · Nikolaos Papanikolaou
Editors
Diffusion Weighted
Imaging of the
Gastrointestinal Tract
Techniques and Clinical Applications
Editors |
|
Sofia Gourtsoyianni |
Nikolaos Papanikolaou |
Department of Radiology |
Head of Computational Clinical Imaging |
Konstantopouleio General Hospital |
Group |
Athens |
Centre for the Unknown, Champalimaud |
Greece |
Foundation |
|
Lisbon |
|
Portugal |
ISBN 978-3-319-92818-0 ISBN 978-3-319-92819-7 (eBook) https://doi.org/10.1007/978-3-319-92819-7
Library of Congress Control Number: 2018950458
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Preface
Imaging the GI tract with MRI has been revolutionary especially for patients with inflammatory bowel disease and in particular for the assessment of small bowel and perianal Crohn’s disease. In addition MRI is the imaging modality of choice for locoregional staging of rectal cancer. Imaging the GI tract with morphological MR sequences hinders challenges as ideally the bowel needs to be void of content and adequately distended and opacified to avoid misinterpretation of bowel wall thickness, which is not always the case.
Technical advances in gradient performance, radiofrequency coils, and pulse sequences have increased the clinical applications of diffusion weighted imaging (DWI) beyond the central nervous system. Especially in GI tract DWI has been shown to provide an additional contrast mechanism that renders GI pathology more conspicuous.
As radiology is moving from the pure anatomical imaging techniques to func- tional-molecular imaging, the use of DWI has gained great acceptance. In the era of “imaging safely” DWI acts as an indispensable noninvasive problem solver. Although it does not seem to be a sophisticated method, radiologists should be aware of all the pearls and pitfalls of DWI in specific diseases and conditions. That was the main concept when writing this book. We aimed to focus on the gastrointestinal applications of DWI in this book, in order to provide a comprehensive coverage of all technical and clinical aspects of MR imaging of the gastrointestinal system. We are fortunate to have had the support and contribution of an outstanding group of internationally renowned authors in this field. Their expertise, cooperation, and effort, which have made this book possible, are greatly appreciated.
Athens, Greece |
Sofia Gourtsoyianni |
Lisbon, Portugal |
Nikolaos Papanikolaou |
v
Contents
1\ \ DWI Techniques and Methods for GI Tract Imaging\ 1 Thierry Metens and Nickolas Papanikolaou
2 Upper Gastrointestinal Tract\ 15 Mirna Al-Khouri, Adel Abdellaoui, and Simon Jackson
3 Small Bowel\ 33 Sonja Kinner
4 Large Bowel\ 53 Luís Curvo Semedo
5 Rectum\ 65 Doenja M. J. Lambregts and Regina G. H. Beets-Tan
6 Anal Canal\ 77 Sofia Gourtsoyianni and Vicky Goh
vii
DWI Techniques and Methods |
1 |
for GI Tract Imaging |
Thierry Metens and Nickolas Papanikolaou
1.1\ Introduction
Diffusion is a mass transport process which results in molecular or particle mixing without requiring bulk motion [1]. For human tissues, water mobility can be assessed in the intracellular, extracellular and intravascular spaces. All media have a different degree of structure and thus pose a variant level of difficulty in water mobility that is called “diffusivity”. An MRI pulse sequence sensitized to microscopic water mobility using strong gradient pulses can be utilized to provide insights into the complexity of the environment which in turn can reveal information related to tissue microarchitecture.
A major requirement in diffusion imaging is to select ultrafast pulse sequences that may freeze macroscopic motion in the form of respiration, peristalsis or patient motion in general. For this reason, echo-planar imaging (EPI) sequences modified with the addition of two identical strong diffusion gradients are routinely used to provide diffusion information. The amplitude and duration of the diffusion gradients are represented by the “b value” (measured in s/mm2), an index used to control the sensitivity of DWI contrast to water mobility.
T. Metens
Department of Radiology, HôpitalErasme, MRI Clinics, Bruxelles, Belgium e-mail: thierry.metens@erasme.ulb.ac.be
N. Papanikolaou (*)
Oncologic Imaging, Computational Clinical Imaging Group Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal
e-mail: npapan@npapan.com
© Springer International Publishing AG, part of Springer Nature 2019 |
1 |
S. Gourtsoyianni, N. Papanikolaou (eds.), Diffusion Weighted Imaging of the Gastrointestinal Tract, https://doi.org/10.1007/978-3-319-92819-7_1