0:01

So for this thing that we're going to

0:02

talk a little bit about how we can use our

0:04

cine images to help us in Crohn's disease.

0:07

So the findings that we expect to see for Crohn's

0:11

involvement in cine images is non-peristalsis

0:14

or stricture of involved segments of bowel.

0:18

And this is a nice case of showing how

0:20

that can at times be really helpful.

0:23

So in this person, you can see that the bowel

0:27

in the lower abdomen here appears

0:28

to be moving fairly normally.

0:30

However, there are segments of bowel

0:32

that just aren't moving at all.

0:33

And take a look at this segment here.

0:35

And what you see is that this

0:37

area is fixed and non-distended.

0:41

It doesn't move at all.

0:43

And it's almost like it's trapped in its location.

0:47

And so the only movement you see is with

0:49

respiratory motion, whereas the upstream

0:51

bowel looks like it's moving fairly normally.

0:53

And that's because this is an involved segment of

0:56

bowel, and not only is it involved with disease,

1:00

but it also appears like there's a fixed stricture here.

1:03

And so cine images can help you both identify

1:05

sites of disease and identify strictures.

1:09

And so when we correlate that to our T2 series,

1:12

what we see is that there's some wall thickening

1:14

and there's some non-distension through this.

1:17

And if we only have this one time point,

1:18

it may be difficult to say whether or

1:21

not that's a stricture, especially if the

1:23

bowel wasn't distended proximally to it.

1:25

However, with the cine images and the advantage

1:28

of multiple time points of MR enterography,

1:31

we can clearly see that this is not just a

1:34

diseased bowel, but it's a strictured bowel.

1:36

And so, we're going to talk a little

1:37

bit more on the next cases about

1:40

what stricturing means and how to

1:42

identify it, and how to classify it.

1:44

But don't forget to use your cine if you have them

1:47

and look for areas of non-motion or areas that just

1:51

never do get distended throughout that period

1:55

that we're imaging during the cine clips.