From August 1, to December 31, , patients with suspected or known small bowel diseases who underwent both CTE and DBE were prospectively enrolled in our study. Segmental involvement is found with intramural haemorrhage, Crohn’s disease, lymphoma, infectious enteritis and ischaemia, particularly due to superior mesenteric artery SMA embolus or superior mesenteric vein SMV thrombosis [ 16 , 22 , 31 – 34 ]. Length of small bowel involvement For the purpose of differential diagnosis, the length of small bowel involvement can be divided into three: MR imaging evaluation of the activity of Crohn’s disease. CT enterography is a new non-invasive imaging technique that offers superior small bowel visualisation compared with standard abdomino-pelvic CT, and provides complementary diagnostic information to capsule endoscopy and MRI enterography. J Med Imaging Radiat Oncol.
CT enterography allows simultaneous assessment of the small and large bowel, and extraluminal disease. Complications of Crohn’s disease: Feedback on why patients did not like DBE is shown in Table 4 , pain during the test Conspicuity of small bowel inflammation at CT enterography: It is important to first distinguish abnormal from normal segments. Segmental involvement is found with intramural haemorrhage, Crohn’s disease, lymphoma, infectious enteritis and ischaemia, particularly due to superior mesenteric artery SMA embolus or superior mesenteric vein SMV thrombosis [ 16 , 22 , 31 – 34 ]. MRE and trans-abdominal ultrasonography US would be alternative radiation-free imaging strategies, due to their equivalent diagnostic accuracy, better tolerance, and cost effectiveness.
Variety of shapes; soft tissue mass with heterogeneous attenuation; duodenal ones can be papillary or polypoid; more distal ones are likely to be annular.
CT enterography usually underestimates the disease extent and severity. Crohn’s disease predominantly involves the mesenteric border of the small bowel, frequently leading to asymmetric inflammation and fibrosis, with pseudosacculation of the antimesenteric border.
A recent survey entterography use of small bowel imaging of Crohn’s disease within National Health Service radiological practice showed that although CT is relatively infrequently used as a first-line test in younger patients without a prior diagnosis, it is commonly performed in those with suspected extraintestinal complications [ 43 ]. Clinical impact of multidetector computed tomography before double-balloon enteroscopy for obscure gastrointestinal bleeding.
CT enterography: review of technique and practical tips
J Nucl Med ; Besides, we did not include via oral DBE in our research because of the small sample size.
Patients prefer propofol to midazolam plus fentanyl for sedation for colonoscopy: Abstract CT enterography is a new non-invasive imaging technique that offers superior small bowel visualisation compared with standard abdomino-pelvic CT, and provides complementary diagnostic information to capsule ch and MRI enterography.
[Full text] Comparison of patients’ tolerance between computed tomography enterogr | PPA
All the Thess examinations were performed by the same endoscopist via the anal approach with conscious sedation injection of 10 mg diazepam intramuscularly before the procedure. Diffuse involvement of the small bowel is commonly a result of hypoalbuminaemia, low-flow intestinal ischaemia, vasculitis, graft vs host disease and infectious enteritis [ 16223036 – 38 ].
Int J Clin Pract.
This article reviews the clinical role of CT enterography, and offers practical tips for optimising technique and accurate interpretation. Small bowel imaging — still a radiologic approach? CT diagnosis of ileal diverticulitis. Feedback on why patients did not like DBE is shown in Table 4pain during the test Journal List Br J Radiol v.
One of the major advantages of CT and other cross-sectional techniques is their ability to visualise the extraluminal soft tissues. Exoenteric mass with adjacent lymphadenopathy and aneurysmal dilatation.
A systematic review and meta-analysis of preference for colonoscopy versus computerized tomographic colonography CTC showed colonoscopy was graded more uncomfortable by patients and CTC was preferred over colonoscopy in most of the studies.
With this in mind, choice of standard abdomino-pelvic CT or CT enterography will be determined by the target of investigation, individualised according to clinical scenario. Accurate detection of small bowel pathology requires careful luminal navigation from the gastro-oesophageal junction to the anus, or vice versa.
In enterlgraphy non-distended loops, other signs of disease must be used to diagnose pathological processes, including associated changes in the adjacent small bowel mesentery such tbesis hypervascularity, fat stranding or lymphadenopathy. Although superior jejunal distension is attained using enteroclysis, the convenience, efficiency and superior patient experience tjesis with CT enterography make it the preferred technique at the authors’ institutions, and therefore the focus of this review.
Heterogeneous enhancement is seen in small bowel neoplasms, including gastrointestinal stromal tumours, adenocarcinomas, metastases and peritoneal deposits. Detection of suspected small bowel bleeding: Patients using sodium picosulfate with magnesium citrate SPMC for bowel preparation were less likely to have abdominal fullness, pain, nausea or vomiting, and reported SPMC to be more palatable compared to PEG, while no difference was shown among the two groups with respect to bowel cleansing grade Ottwa Scale.
Slice thickness of 2 mm with reconstruction interval of 0.
CT enterography: review of technique and practical tips
Recommended protocol Table 1 provides a summary of the technique used in our institution, which has evolved over 4 years and CT enterography examinations. As discussed below, differential contrast enhancement is a cardinal sign enterographt many small bowel pathologies.
Coronal CT enterography image showing mural thickening and mucosal hyperenhancement long arrows. Multiphase CT enterography evaluation of small-bowel vascular lesions. Consideration must be made as to the age of the patient, their past diagnostic history, previous imaging and endoscopic examinations and general well-being, as well as the specific clinical question and availability of imaging platforms and interpretative radiological expertise.