Andreas Sturm,a Christian Maaser,b Emma Calabrese,c Vito Annese,d Gionata Fiorino,e Torsten Kucharzik,f Stephan R. Vavricka,g Bram Verstockt,h, Patrick van Rheenen,i Damian Tolan,j Stuart A. Taylor,k Jordi Rimola,l Florian Rieder,m Jimmy K. Limdi,n Andrea Laghi,o Eduards Krustiņš,p Paulo G. Kotze,q Uri Kopylov,r Konstantinos Katsanos,s Steve Halligan,t Hannah Gordon,u Yago González Lama,v Pierre Ellul,w Rami Eliakim,r Fabiana Castiglione,x Johan Burisch,y, Paula Borralho Nunes,z, Dominik Bettenworth,aa Daniel C. Baumgart,bb Jaap Stoker,cc on behalf of the European Crohn’s and Colitis Organisation [ECCO] and the European Society of Gastrointestinal and Abdominal Radiology [ESGAR]

https://www.zora.uzh.ch/id/eprint/181192/1/2018_05_02_Manuscript2_ECCO_ESGAR-DiagnosticsGL_c4-5.pdf

Ecco-esgar guideline for diagnostic assessment in ibd part 2: Ibd scores and general principles and technical aspects

Objective To present an approach, based on current evidence, for the diagnosis, treatment, and thromboprophylaxis of venous thromboembolism in pregnancy and postpartum. Evidence Published literature was retrieved through searches of PubMed, Medline, CINAHL, and The Cochrane Library from November 2011 to July 2013 using appropriate controlled vocabulary (e.g. pregnancy, venous thromboembolism, deep vein thrombosis, pulmonary embolism, pulmonary thrombosis) and key words (e.g., maternal morbidity, pregnancy complications, thromboprophylaxis, antithrombotic therapy). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English or French. There were no date restrictions. Grey (unpublished) literature was identified through searching the websites of clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Values The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventative Health Care (Table 1).

https://www.jogc.com/article/S1701-2163(15)30569-7/pdf

Venous Thromboembolism and Antithrombotic Therapy in Pregnancy

MR enteroclysis should be recommended as the initial imaging examination in patients suspected of having inflammatory or neoplastic small-bowel diseases.

MR Imaging of the Small Bowel

These guidelines update the previous EANM 2009 guidelines on the diagnosis of pulmonary embolism (PE). Relevant new aspects are related to (a) quantification of PE and other ventilation/perfusion defects; (b) follow-up of patients with PE; (c) chronic PE; and (d) description of additional pulmonary physiological changes leading to diagnoses of left ventricular heart failure (HF), chronic obstructive pulmonary disease (COPD) and pneumonia. The diagnosis of PE should be reported when a mismatch of one segment or two subsegments is found. For ventilation, Technegas or krypton gas is preferred over diethylene triamine pentaacetic acid (DTPA) in patients with COPD. Tomographic imaging with V/PSPECT has higher sensitivity and specificity for PE compared with planar imaging. Absence of contraindications makes V/PSPECT an essential method for the diagnosis of PE. When V/PSPECT is combined with a low-dose CT, the specificity of the test can be further improved, especially in patients with other lung diseases. Pitfalls in V/PSPECT interpretation are discussed. In conclusion, V/PSPECT is strongly recommended as it accurately establishes the diagnosis of PE even in the presence of diseases like COPD, HF and pneumonia and has no contraindications.

https://link.springer.com/content/pdf/10.1007%2Fs00259-019-04450-0.pdf

EANM guideline for ventilation/perfusion single-photon emission computed tomography (SPECT) for diagnosis of pulmonary embolism and beyond

Objectives
To develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease.

/pdf/the-first-joint-esgar-espr-consensus-statement-on-the-2tt4i9k1a4.pdf

The first joint ESGAR/ ESPR consensus statement on the technical performance of cross-sectional small bowel and colonic imaging

OBJECTIVE. The purpose of this study was to compare the image quality of a standard pulmonary CT angiography (CTA) protocol with a pulmonary CTA protocol optimized for use in pregnant patients with suspected pulmonary embolism (PE). MATERIALS AND METHODS. Forty-five consecutive pregnant patients with suspected PE were retrospectively included in the study: 25 patients (group A) underwent standard-protocol pulmonary CTA and 20 patients (group B) were imaged using a protocol modified for pregnancy. The modified protocol used a shallow inspiration breath-hold and a high concentration, high rate of injection, and high volume of contrast material. Objective image quality and subjective image quality were evaluated by measuring pulmonary arterial enhancement, determining whether there was transient interruption of the contrast bolus by unopacified blood from the inferior vena cava (IVC), and assessing diagnostic adequacy. RESULTS. Objective and subjective image quality were significantly better for group B—that...

https://www.ajronline.org/doi/pdf/10.2214/AJR.10.5385

Pulmonary CT Angiography Protocol Adapted to the Hemodynamic Effects of Pregnancy

To date, cross-sectional imaging of the duodenum has a number of inadequacies, most likely a reflection of its tortuous and complex anatomical course, resulting in somewhat suboptimal imaging. The purpose of this study was to describe and assess the feasibility of performing a ‘tubeless’, per-oral, single contrast, hypotonic magnetic resonance (MR) duodenography technique. Secondly, to assess the efficacy of intravenous Buscopan in facilitating duodenal distension at cross-sectional MR imaging. Ten healthy volunteers prospectively underwent MR imaging of the duodenum pre- and post-Buscopan immediately after consuming 1,000 ml of water. Images were qualitatively (using a visual assessment grading scale of 1–3) and quantitatively evaluated with regard to degree of small bowel distension by two observers. The contrast medium was successfully ingested and MR examination was completed in all participants. Quantitatively and qualitatively, the per-oral, hypotonic duodenography technique yielded superior distension scores and was significantly greater in diameter in comparison with the per-oral non-hypotonic duodenography technique (p < 0.003, p < 0.002). Per-oral, single-contrast, hypotonic MR duodenography is a feasible, simple, fast mode of investigation of the duodenum, which does not involve radiation and represents a useful technique in the armamentarium of the radiologist.

Hypotonic MR duodenography with water ingestion alone: feasibility and technique.

Purpose:To report a combined procedure that opens the acutely thrombosed superior vena cava (SVC) to rapidly alleviate symptoms in seriously ill patients with SVC syndrome.Case Reports:Four patient...

Isolated pharmacomechanical thrombolysis plus primary stenting in a single procedure to treat acute thrombotic superior vena cava syndrome.

OBJECTIVE. The purpose of this study was to assess whether prone or supine imaging provides superior small-bowel loop distention during MRI small-bowel follow-through examinations and whether either position is better with regard to lesion detection and evaluation.SUBJECTS AND METHODS. Forty consecutively enrolled clinically referred patients with known or suspected small-bowel abnormalities prospectively underwent 62 MRI small-bowel follow-through examinations in both the prone and the supine positions. Images were blindly and independently reviewed by two observers. Each small-bowel segment was assessed with a 3-point scoring system, and differences in bowel distention in the prone and supine positions were evaluated with a paired Wilcoxon's test. Differences between rates of lesion detection and characterization (e.g., ulceration, stricturing) were analyzed with a paired Student's t test. Interobserver agreement was estimated with the kappa coefficient.RESULTS. In both normal and diseased small bowel, ...

https://www.ajronline.org/doi/pdfplus/10.2214/AJR.07.2338

MRI small-bowel follow-through: prone versus supine patient positioning for best small-bowel distention and lesion detection.

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Pulmonary CT Angiography Protocol Adapted to the Hemodynamic Effects of Pregnancy

Hypotonic MR duodenography with water ingestion alone: feasibility and technique.

Isolated pharmacomechanical thrombolysis plus primary stenting in a single procedure to treat acute thrombotic superior vena cava syndrome.

MRI small-bowel follow-through: prone versus supine patient positioning for best small-bowel distention and lesion detection.