Imaging diagnosis and evaluation of radiation-induced intestinal injury

Abstract

Radiation-induced intestinal injury significantly impacts the quality of life and even prognosis of patients. Timely diagnosis and accurate assessment are crucial in clinical practice. Imaging examinations play a vital role in the diagnosis and evaluation of radiation-induced intestinal injury. CT offers fast scanning speed and wide coverage but has limited soft tissue resolution. On the other hand, MRI offers superior soft tissue resolution, along with the capability for multi-sequence and multi-parameter imaging, and the ability to assess the effect of tumor treatment. However, its scanning range is restricted. Endorectal ultrasound enables observation of rectal wall thickness, submucosal blood flow signals, and the development of micro-ulcers and fistulas. The key imaging features of radiation-induced intestinal injury include intestinal wall thickening, layered enhancement on contrast-enhanced scans, fistula formation, and abscess formation, and so on. Previous studies have established correlations between certain imaging features and the severity as well as prognosis of the disease. Nonetheless, these imaging features lack specificity, and require differentiation from tumors, ischemic changes, and other intestinal inflammatory lesions, considering the patient's radiotherapy history in conjunction with the imaging findings.