Interactive Transcript
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All right, so now that we've talked about Crohn's and
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a little bit about how we perform enterography and
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the anatomy, we get to talk about the pathology in
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Crohn's and what we typically see for these patients.
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And so here's a pretty classic, typical case
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of active Crohn's disease and what we see.
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And so when we approach these cases, I'm going
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to give you a quick overview about how I talk
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about it, and then we'll talk in depth about
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all the individual findings and how to discuss
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those findings, what's important to talk about,
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and how much detail that I go into and how much
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detailed experts recommend people put into reports.
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And so here's a case of Crohn's with
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active terminal ileal and sickle disease.
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And what you see on each sequence is different.
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So for our T2 sequence, what we
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see is that the wall is thickened.
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We see there's some edema that we want to
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verify with our fat-saturated sequences.
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To make sure it's not fat, but it does look
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brighter than the adjacent muscle.
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So we're thinking that's edema.
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And, um, we also see that there's some
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abnormal signal in the fat surrounding.
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This is a fat-saturated sequence.
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The fat saturation isn't great peripherally,
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but it's pretty good in the abdomen.
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So I think this, this works and
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you can see that is true edema.
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The true FISP isn't as critical in this case
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because we have good quality T2 images, but
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we see the same findings on our true FISP
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or steady-state precession sequence.
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On the pre-contrast, we can kind of get a sense
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that that wall is thickened, but then as we move
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to the post-contrast, it really jumps out at us
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that this, this is an abnormal segment of bowel.
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So we see a lot of inflammation extending
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up into the ascending colon down
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through the TI into that distal ileum.
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And so that hyperenhancement on the
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early phase tells us that this looks to
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be pretty active inflammatory changes.
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When we look at our axial sequences,
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we see the same, same findings.
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Again, we want to compare that to the
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adjacent bowel and see that it is clearly
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hyperenhancing inflammatory change.
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And so that's the general findings that we see that
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make up the classic hallmarks of identifying Crohn's
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disease, but once we've identified the disease, we do
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want to talk in pretty good detail about the different
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findings because each finding that we see can have
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different implications for whether it's a chronic
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disease and can have implications for how severe the
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disease is and what kind of management is needed.
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So for the next piece, we're going to talk individually
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about the different types of findings, how to talk
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about them, and what to be looking for when we do that.
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