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Diagnostics
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Diagnostic Imaging in Gastrointestinal Diseases
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Diagnostic Imaging in Gastrointestinal Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 9991

Special Issue Editor

Dr. Min-jeong Kim

E-Mail Website
Guest Editor
Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
Interests: radiology; liver MR imaging; LI-RADS; gastrointestinal diseases; ultrasonography

Special Issue Information

Dear Colleagues,

This Special Issue, "Diagnostic Imaging in Gastrointestinal Diseases", aims to provide a comprehensive overview of the latest advances and emerging trends in the field of gastrointestinal imaging. Its scope includes the use of various imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), endoscopy, and ultrasound, for the diagnosis of gastrointestinal diseases. The field of gastrointestinal imaging has seen significant advancements in techniques, and staying up-to-date with the latest imaging modalities enhances diagnostic accuracy and patient care. It presents cutting-edge research and expert opinions covering a broad range of topics, including imaging of the esophagus, stomach, small intestine, colon, rectum, and anus, as well as functional and motility disorders. The ultimate goal of this Special Issue is to demonstrate the diagnostic abilities of gastrointestinal imaging and to facilitate the development of new imaging techniques that can improve patient outcomes. Your valuable studies in all areas of the gastrointestinal tract will be welcomed.

Dr. Min-jeong Kim
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (7 papers)

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Research

Jump to: Review, Other

10 pages, 6388 KiB  
Article
Clinical Usefulness of Immune Profiling for Differential Diagnosis between Crohn’s Disease, Intestinal Tuberculosis, and Behcet’s Disease
by Ji Won Yoo, Su In Jo, Dong Woo Shin, Ji Won Park, Sung-Eun Kim, Hyun Lim, Ho Suk Kang, Sung-Hoon Moon, Min Kyu Kim, Sang-Yeob Kim, Sung Wook Hwang and Jae Seung Soh
Diagnostics 2023, 13(18), 2904; https://doi.org/10.3390/diagnostics13182904 - 11 Sep 2023
Viewed by 1024
Abstract
It is important to make a differential diagnosis between inflammatory diseases of the bowel with similar clinical and endoscopic features. The profiling of immune cells could be helpful for accurately diagnosing inflammatory bowel diseases. We compared immune marker expression between Crohn’s disease (CD), [...] Read more.
It is important to make a differential diagnosis between inflammatory diseases of the bowel with similar clinical and endoscopic features. The profiling of immune cells could be helpful for accurately diagnosing inflammatory bowel diseases. We compared immune marker expression between Crohn’s disease (CD), intestinal Behcet’s disease (BD), and intestinal tuberculosis (TB) and evaluated the usefulness of immune profiling in differentiating between these diseases. Biopsy specimens were acquired around ulcerations on the terminal ileum or cecum from five patients with each disease. Panel 1 included multiplex immunohistochemistry staining for CD8, CD4, Foxp3, CD20, programmed death-1, and granzyme B. CD56, CD68, CD163, CD11c, and HLA-DR were analyzed in panel 2. The differences in cytotoxic T cells (CD8+CD4−Fopx3−CD20−), helper T cells (CD8−CD4+Fopx3−CD20−), and regulatory T cells (CD8−CD4+Fopx3+CD20−) were also not significant. However, M1 macrophage (CD68+CD163−HLA−DR−) cell densities were significantly higher in intestinal BD than in other diseases. The expression level of dendritic cells (CD56−CD68−CD163−CD11c+HLA-DR+) was highest in intestinal TB and lowest in intestinal BD. The expression of immune cells, including M1 macrophages and dendritic cells, was different between CD, intestinal BD, and intestinal TB. Immune profiling can be helpful for establishing differential diagnoses of inflammatory bowel diseases. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Gastrointestinal Diseases)
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20 pages, 2090 KiB  
Article
Preoperative Assessment of Perianal Fistulas with Combined Magnetic Resonance and Tridimensional Endoanal Ultrasound: A Prospective Study
by Nikolaos Varsamis, Christoforos Kosmidis, Grigorios Chatzimavroudis, Fani Apostolidou Kiouti, Christoforos Efthymiadis, Vasilis Lalas, Chrysi Maria Mystakidou, Christina Sevva, Konstantinos Papadopoulos, George Anthimidis, Charilaos Koulouris, Alexandros Vasileios Karakousis, Konstantinos Sapalidis and Isaak Kesisoglou
Diagnostics 2023, 13(17), 2851; https://doi.org/10.3390/diagnostics13172851 - 03 Sep 2023
Cited by 2 | Viewed by 1624
Abstract
Background: we designed a prospective study of diagnostic accuracy that compared pelvic MRI and 3D-EAUS with pelvic MRI alone in the preoperative evaluation and postoperative outcomes of patients with perianal fistulas. Methods: the sample size was 72 patients and this was divided into [...] Read more.
Background: we designed a prospective study of diagnostic accuracy that compared pelvic MRI and 3D-EAUS with pelvic MRI alone in the preoperative evaluation and postoperative outcomes of patients with perianal fistulas. Methods: the sample size was 72 patients and this was divided into two imaging groups. MRI alone was performed on the first group. Both MRI and 3D-EAUS were performed in parallel on the second group. Surgical exploration took place after two weeks and was the standard reference. Park’s classification, the presence of a concomitant abscess or a secondary tract, and the location of the internal opening were recorded. All patients were re-evaluated for complete fistula healing and fecal incontinence six months postoperatively. All of the collected data were subjected to statistical analysis. Results: the MRI group included 36 patients with 42 fistulas. The MRI + 3D-EAUS group included 36 patients with 46 fistulas. The adjusted sensitivity and negative predictive value were 1.00 for most fistula types in the group that underwent combined imaging. The adjusted specificity improved for intersphincteric fistulas in the same group. The adjusted balanced accuracy improved for all fistula types except rectovaginal. The combination of imaging methods showed improved diagnostic accuracy only in the detection of a secondary tract. The healing rate at six months was 100%. Fecal incontinence at six months did not present a statistically significant difference between the two groups (Fisher’s exact test p-value > 0.9). Patients with complex perianal fistulas had a statistically significant higher probability of undergoing a second surgery (x2 test p-value = 0.019). Conclusions: the combination of pelvic MRI and 3D-EAUS showed improved metrics of diagnostic accuracy and should be used in the preoperative evaluation of all patients with perianal fistulas, especially those with complex types. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Gastrointestinal Diseases)
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12 pages, 3947 KiB  
Article
Retrospective Cohort Study of Shear-Wave Elastography and Computed Tomography Enterography in Crohn’s Disease
by Minping Zhang, Enhua Xiao, Minghui Liu, Xilong Mei and Yinghuan Dai
Diagnostics 2023, 13(11), 1980; https://doi.org/10.3390/diagnostics13111980 - 05 Jun 2023
Cited by 6 | Viewed by 1546
Abstract
Distinguishing between inflammatory and fibrotic lesions drastically influences treatment decision-making regarding Crohn’s disease. However, it is challenging to distinguish these two phenotypes before surgery. This study investigates the diagnostic yield of shear-wave elastography and computed tomography enterography to distinguish intestinal phenotypes in Crohn’s [...] Read more.
Distinguishing between inflammatory and fibrotic lesions drastically influences treatment decision-making regarding Crohn’s disease. However, it is challenging to distinguish these two phenotypes before surgery. This study investigates the diagnostic yield of shear-wave elastography and computed tomography enterography to distinguish intestinal phenotypes in Crohn’s disease. Thirty-seven patients (mean age, 29.51 ± 11.52; 31 men) were evaluated with average value of shear-wave elastography (Emean) and computed tomography enterography (CTE) scores. The results demonstrated that a positive correlation between the Emean and fibrosis (Spearman’s r = 0.653, p = 0.000). The cut-off value for fibrotic lesions was 21.30 KPa (AUC: 0.877, sensitivity: 88.90%, specificity: 89.50%, 95% CI:0.755~0.999, p = 0.000). The CTE score showed a positive correlation with inflammation (Spearman’s r = 0.479, p = 0.003), and a 4.5-point grading system was the optimal cut-off value for inflammatory lesions (AUC: 0.766, sensitivity: 73.70%, specificity: 77.80%, 95% CI: 0.596~0.936, p = 0.006). Combining these two metrics improved the diagnostic performance and specificity (AUC: 0.918, specificity: 94.70%, 95% CI: 0.806~1.000, p = 0.000). In conclusion, shear-wave elastography can be used to help detect fibrotic lesions and the computed tomography enterography score emerged as a feasible predictor of inflammatory lesions. The combination of these two imaging techniques is proposed to distinguish intestinal predominant phenotypes. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Gastrointestinal Diseases)
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12 pages, 10281 KiB  
Article
Acute Ileal Diverticulitis: Computed Tomography and Ultrasound Findings
by Lyo Min Kwon, Kwanseop Lee, Min-Jeong Kim, In Jae Lee and Gab Chul Kim
Diagnostics 2023, 13(8), 1408; https://doi.org/10.3390/diagnostics13081408 - 13 Apr 2023
Viewed by 2444
Abstract
Background: Acute ileal diverticulitis is a rare disease mimicking acute appendicitis. Inaccurate diagnosis with a low prevalence and nonspecific symptoms leads to delayed or improper management. Methods: This retrospective study aimed to investigate the characteristic sonographic (US) and computed tomography (CT) findings with [...] Read more.
Background: Acute ileal diverticulitis is a rare disease mimicking acute appendicitis. Inaccurate diagnosis with a low prevalence and nonspecific symptoms leads to delayed or improper management. Methods: This retrospective study aimed to investigate the characteristic sonographic (US) and computed tomography (CT) findings with clinical features in seventeen patients with acute ileal diverticulitis diagnosed between March 2002 and August 2017. Results: The most common symptom was abdominal pain (82.3%, 14/17) localized to the right lower quadrant (RLQ) in 14 patients. The characteristic CT findings of acute ileal diverticulitis were ileal wall thickening (100%, 17/17), identification of inflamed diverticulum at the mesenteric side (94.1%, 16/17), and surrounding mesenteric fat infiltration (100%, 17/17). The typical US findings were outpouching diverticular sac connecting to the ileum (100%, 17/17), peridiverticular inflamed fat (100%, 17/17), ileal wall thickening with preserved layering pattern (94.1%, 16/17), and increased color flow to the diverticulum and surrounding inflamed fat on color Doppler imaging (100%, 17/17). The perforation group had a significantly longer hospital stay than non-perforation group (p = 0.002). In conclusion, acute ileal diverticulitis has characteristic CT and US findings that allow radiologists to accurately diagnose the disease. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Gastrointestinal Diseases)
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Review

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18 pages, 2863 KiB  
Review
Gastroenteropancreatic Neuroendocrine Tumors—Current Status and Advances in Diagnostic Imaging
by Daniel Vogele, Stefan A. Schmidt, Daniel Gnutzmann, Wolfgang M. Thaiss, Thomas J. Ettrich, Marko Kornmann, Meinrad Beer and Markus S. Juchems
Diagnostics 2023, 13(17), 2741; https://doi.org/10.3390/diagnostics13172741 - 23 Aug 2023
Cited by 1 | Viewed by 951
Abstract
Gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN) is a heterogeneous and complex group of tumors that are often difficult to classify due to their heterogeneity and varying locations. As standard radiological methods, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography–computed tomography (PET/CT) [...] Read more.
Gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN) is a heterogeneous and complex group of tumors that are often difficult to classify due to their heterogeneity and varying locations. As standard radiological methods, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography–computed tomography (PET/CT) are available for both localization and staging of NEN. Nuclear medical imaging methods with somatostatin analogs are of great importance since radioactively labeled receptor ligands make tumors visible with high sensitivity. CT and MRI have high detection rates for GEP-NEN and have been further improved by developments such as diffusion-weighted imaging. However, nuclear medical imaging methods are superior in detection, especially in gastrointestinal NEN. It is important for radiologists to be familiar with NEN, as it can occur ubiquitously in the abdomen and should be identified as such. Since GEP-NEN is predominantly hypervascularized, a biphasic examination technique is mandatory for contrast-enhanced cross-sectional imaging. PET/CT with somatostatin analogs should be used as the subsequent method. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Gastrointestinal Diseases)
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Other

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12 pages, 913 KiB  
Systematic Review
Endoscopic Ultrasound to Identify the Actual Cause of Idiopathic Acute Pancreatitis: A Systematic Review
by Francesco Cammarata, Lucrezia Rovati, Paola Fontana, Pietro Gambitta, Antonio Armellino and Paolo Aseni
Diagnostics 2023, 13(20), 3256; https://doi.org/10.3390/diagnostics13203256 - 19 Oct 2023
Cited by 1 | Viewed by 1234
Abstract
Idiopathic acute pancreatitis (IAP) presents a diagnostic challenge and refers to cases where the cause of acute pancreatitis remains uncertain despite a comprehensive diagnostic evaluation. Endoscopic ultrasound (EUS) has emerged as a valuable tool in the diagnostic workup of IAP. This review explores [...] Read more.
Idiopathic acute pancreatitis (IAP) presents a diagnostic challenge and refers to cases where the cause of acute pancreatitis remains uncertain despite a comprehensive diagnostic evaluation. Endoscopic ultrasound (EUS) has emerged as a valuable tool in the diagnostic workup of IAP. This review explores the pivotal role of EUS in detecting the actual cause of IAP and assessing its accuracy, timing, safety, and future technological improvement. In this review, we investigate the role of EUS in identifying the actual cause of IAP by examining the available literature. We aim to assess possible existing evidence regarding EUS accuracy, timing, and safety and explore potential trends of future technological improvements in EUS for diagnostic purposes. Following PRISMA guidelines, 60 pertinent studies were selected and analysed. EUS emerges as a crucial diagnostic tool, particularly when conventional imaging fails. It can offer intricate visualization of the pancreas, biliary system, and adjacent structures. Microlithiasis, biliary sludge, chronic pancreatitis, and small pancreatic tumors seem to be much more accurately identified with EUS in the setting of IAP. The optimal timing for EUS is post-resolution of the acute phase of the disease. With a low rate of complications, EUS poses minimal safety concerns. EUS-guided interventions, including fine-needle aspiration, collection drainage, and biopsies, aid in the cytological analysis. With high diagnostic accuracy, safety, and therapeutic potential, EUS is able to improve patient outcomes when managing IAP. Further refinement of EUS techniques and cost-effectiveness assessment of EUS-guided approaches need to be explored in multicentre prospective studies. This review underscores EUS as a transformative tool in unraveling IAP’s enigma and advancing diagnostic and therapeutic strategies. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Gastrointestinal Diseases)
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4 pages, 5647 KiB  
Interesting Images
The Usefulness of Magnetic Resonance Imaging in the Management of Acute Phlegmonous Esophagitis
by Motohiro Shimizu, Hiroshi Adachi and Kenichi Sai
Diagnostics 2023, 13(15), 2600; https://doi.org/10.3390/diagnostics13152600 - 04 Aug 2023
Viewed by 697
Abstract
Acute phlegmonous esophagitis is a rare life-threatening disease that often requires surgical intervention in case of complications, including esophageal abscess, perforation, or mediastinitis. We present a case of acute phlegmonous esophagitis, in which magnetic resonance imaging (MRI) proved useful in planning the treatment [...] Read more.
Acute phlegmonous esophagitis is a rare life-threatening disease that often requires surgical intervention in case of complications, including esophageal abscess, perforation, or mediastinitis. We present a case of acute phlegmonous esophagitis, in which magnetic resonance imaging (MRI) proved useful in planning the treatment strategy. An 89-year-old woman was admitted to the emergency department with painful swallowing and respiratory distress. She was diagnosed with acute phlegmonous esophagitis and a hypopharyngeal abscess based on computed tomography (CT) findings. However, there was a discrepancy between the clinical course and CT findings. Given the improvement of the patient’s condition with conservative treatment with ampicillin/sulbactam, the CT findings suggested an apparent abscess due to increased esophageal wall thickness. However, MR diffusion-weighted images showed a slightly high-intensity signal, suggesting that the enlargement was due to edema rather than an abscess. The patient recovered successfully following conservative treatment. Thus, our findings demonstrate the utility of MRI in the treatment planning of acute phlegmonous esophagitis, especially in cases with unreliable contrast-enhanced CT findings. However, future studies are warranted to explore the utility of MRI in the management of such cases. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Gastrointestinal Diseases)
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