CT Enterography: Principles, Trends, and Interpretation of Findings

Elsayes, Khaled M.; Al-Hawary, Mahmoud M.; Jagdish, J.; Ganesh, Halemane; Platt, Joel F.

doi:10.1148/rg.307105052

Cited by 132 publications

(84 citation statements)

References 47 publications

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“…Diagnostic methods in patients with obscure GI bleeding include enteroclysis, angiography, push enteroscopy, and capsule endoscopy for the evaluation; all of these techniques are relatively insensitive and have low diagnostic yields to detect MD in the small bowel (8). Recent studies have suggested that CT enterography is a useful method for diagnosis of small bowel lesions (9,10). CT enterography is easily accessible and minimally invasive and requires relatively short examination times.…”

Section: Discussionmentioning

confidence: 99%

Meckel’s diverticulum detected by computed tomographic enterography: Report of 3 cases and review of the literature

Lee

Jeen²,

Kim³

et al. 2014

Turk J Gastroenterol

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Meckel's diverticulum is a common anomaly of the small intestine and occasionally presents as obscure gastrointestinal hemorrhage. Before operation, it is difficult to diagnose by imaging, especially in adults. Conventional abdominal computed tomography and endoscopy have limitations for the diagnosis of Meckel's diverticulum. Diagnostic methods in patients with small bowel lesions include enteroclysis, angiography, push enteroscopy, and capsule endoscopy; however, all of these techniques have low diagnostic yields to detect Meckel's diverticulum. Recently, computed tomographic enterography has been reliable in assessing small bowel disease. We present 3 cases of Meckel's diverticulum with bleeding in adults who were diagnosed by computed tomographic enterography. The bleeding source was not found in the total colonoscopy, and Tc-99m pertechnetate scans were negative in these patients. However, outpouching structures of the distal ileum with enhancement were detected by computed tomographic enterography. All patients underwent small bowel segmental resection. Meckel's diverticulum was confirmed by histopathology of the resected ileum segment, and the type of heterotopic tissue was gastric mucosa.

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Section: Discussionmentioning

confidence: 99%

Meckel’s diverticulum detected by computed tomographic enterography: Report of 3 cases and review of the literature

Lee

Jeen²,

Kim³

et al. 2014

Turk J Gastroenterol

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“…Instead, neutral contrast agents are preferred, typi cally 0.1% wt/vol barium sulfate suspension (VoLumen; Braco Diagnostics, Princeton, NJ, United States), al though a few other products are also commercially avail able [6,7] . Notably, the literature suggests that VoLumen (compared to other neutral and positive contrast media) provides the best distension of the small bowel.…”

Section: Ct Enterography Techniquementioning

confidence: 99%

“…Notably, however, intramural fat deposi tion is a nonspecific finding that can be seen not only in other causes of chronic bowel inflammation, but also in the setting of obesity, steroid use, and diabetes [8] . As a result of the disease's preferential involvement of the mesenteric side of the bowel, asymmetric fibrosis and pseudosacculations along the mesenteric border are also common in the chronic setting [6] . CT enterography can also be helpful in identifying sites of strictures and narrowing, representing sites of fibrosis as a result of prior bouts of active inflammation.…”

Section: Chronic Bowel Diseasementioning

confidence: 99%

“…In some cases, it can be difficult to determine if a site of luminal narrowing is secondary to active inflammation or chron ic fibrosis, particularly in the absence of adjacent inflam matory change and mesenteric hyperemia [24] . Regardless of whether luminal narrowing is acute or chronic, the presence of a stricture is a critical finding to communi cate to gastroenterologists, as small bowel endoscopy in this setting can result in capsule retention and small bowel obstruction [6] .…”

Section: Chronic Bowel Diseasementioning

confidence: 99%

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Computed tomography of Crohn’s disease: The role of three dimensional technique

Raman

Horton²,

Fishman³

2013

WJR

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the proper use of 3-D technique (including volume rendering and maximum intensity projection) as a routine component of enterography interpretation can play a vital role in improving diagnostic accuracy.© 2013 Baishideng. All rights reserved. Key words:Crohn's disease; Computed tomography angiography; Multidetector computed tomography; Three dimensional technique; Volume rendering; Maximum intensity projection; Fistula; Dose reduction Core tip: Advancements in computed tomography (CT) enterography protocol design, three dimensional (3-D) post-processing software, and CT scanner technology have allowed increasing accuracy in diagnosis, and the acquisition of studies at a much lower radiation dose. The cases in this review will illustrate that the use of 3-D technique, proper enterography protocol design, and a detailed understanding of the different manifestations of Crohn's disease are all critical in properly diagnosing the full range of possible complications in Crohn's patients. INTRODUCTIONCrohn's disease, a form of transmural inflammatory bo wel disease affecting over 1.5 million Americans and Eu ropeans, remains a difficult entity to diagnose clinically: While involvement of any segment of the gastrointestinal tract is possible, the disease most often affects the mes enteric small bowel, making direct endoscopic evaluation and biopsy difficult. Moreover, symptoms tend to be nonspecific, and there are no clinical symptoms or labora AbstractCrohn's disease, a transmural inflammatory bowel disease, remains a difficult entity to diagnose clinically. Over the last decade, multidetector computed tomography (CT) has become the method of choice for noninvasive evaluation of the small bowel, and has proved to be of significant value in the diagnosis of Crohn's disease. Advancements in CT enterography protocol design, three dimensional (3-D) post-processing software, and CT scanner technology have allowed increasing accuracy in diagnosis, and the acquisition of studies at a much lower radiation dose. The cases in this review will illustrate that the use of 3-D technique, proper enterography protocol design, and a detailed understanding of the different manifestations of Crohn's disease are all critical in properly diagnosing the full range of possible complications in Crohn's patients. In particular, CT enterography has proven to be effective in identifying involvement of the small and large bowel (including active inflammation, stigmata of chronic inflammation, and Crohn's-related bowel neoplasia) by Crohn's disease, as well as the extra-enteric manifestations of the disease, including fistulae, sinus tracts, abscesses, and urologic/hepatobiliary/osseous complications. Moreover, Raman SP et al . 3-D MDCT imaging of Crohn's disease

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“…The superficial erosions in early or mild UC are below the resolution of CT and MRI. However, one severe complication of UC, and a leading cause of death, is toxic megacolon, in which inflammation leads to destruction of ganglion cells and consequent colonic dilation (Elsayes et al, 2010). In these acutely ill patients, non-invasive methods are preferred to endoscopy.…”

Section: Introductionmentioning

confidence: 99%