0:01

Okay, so sticking with the same case here,

0:04

one of the main findings that we see is something

0:05

called segmental mural hyperenhancement.

0:08

And again, we see that especially well on the earlier

0:12

phases of the arterial phases, this segment of bowel

0:15

is clearly enhancing more than the adjacent segments.

0:18

So, for the ileum, we want to compare the

0:21

involved segment to the adjacent loops of ileum.

0:24

And we see that there's a big segment of

0:25

bowel that's hyperenhancing in this region.

0:28

For the cecum, we want to compare the segment

0:33

of cecum to the more proximal ascending colon.

0:36

And we see that that's also clearly hyperenhancing.

0:39

So, the segmental mural hyperenhancement

0:42

has a moderate sensitivity and specificity for

0:45

Crohn's disease, but other things can cause this.

0:47

So, we do need to go beyond that before

0:51

we can say that it's definitely Crohn's disease.

0:54

And so, we'll talk about some other patterns of

0:56

enhancement that we also need to be looking for.

1:00

In addition to Crohn's disease, you can

1:01

have things like ulcerative colitis with backwash ileitis,

1:06

infectious etiologies,

1:09

autoimmune things, graft-versus-host

1:10

type disease, even NSAID enteropathy;

1:13

all those things can cause hyperenhancement.

1:15

And so, the differential is actually pretty

1:17

broad when all you have is hyperenhancement.

1:19

So, you need to look at other factors as well.

1:22

And so, we'll show a few more cases

1:24

showing this and then what other things

1:26

to look for in terms of hyperenhancement.