Abstract
1.1. Introduction and aims: Intestinal lymphangiectasia (IL) is a rare protein losing enteropathy caused by congenital malformation or obstruction of the intestinal lymphatic system. Determining presence and extent of involvement is challenging, as if the region of involvement is further to the duodenum it’s not visualized by upper GI endoscopy. Computerized tomography (CT) scan and video capsule endoscopy (VCE) can be used but their use is limited by size of capsule endoscope and radiation exposure in CT scanning. Hence we evaluated MRI for confirming the diagnosis and evaluating the extent of intestinal involvement. 1.2. Methods and patients: 4 children with confirmed primary IL underwent MRI scan to evaluate dilated lymphatics and extent of disease. 1.3. Image analysis: Images were analyzed for the presence of bowel wall thickness, presence of intestinal obstruction, mesenteric lymphangiectasia, hypodense intramural focus in bowel wall, T2WI hyper-intense focal area in the bowel wall and any other associated abnormality. 1.4. Results: Bowel thickening and dilated lymphatics seen as tubular hyper-intense channels in the sub-serosal layers within the small bowel walls were seen. Segmental localization to isolated jejunal involvement was observed in one patient. 1.5. Conclusion: MRI can be used to diagnose and evaluate extent of involvement of intestinal lymphangiectasia.
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