CT enterography: state-of-the-art CT technique for small bowel imaging

Ghonge, Nitin P; Aggarwal, Bharat; Gothi, Rajesh

doi:10.1007/s12664-013-0307-4

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…It can also help in localisation of active bleeding as the presence of active GI bleeding would be seen as a focal area of hyperdense attenuation in the bowel lumen on plain scan or as focal area of contrast enhancement or extravasation into the lumen on a contrast-enhanced study [84]. Lee and co-workers evaluated the diagnostic performance of CTE in 65 patients of OGIB [85].…”

Section: Management Of Small Bowel Bleedmentioning

confidence: 99%

Small bowel bleeding: a comprehensive review

Gunjan

Sharma

Bhasin

2014

Gastroenterology Report

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The small intestine is an uncommon site of gastro-intestinal (GI) bleeding; however it is the commonest cause of obscure GI bleeding. It may require multiple blood transfusions, diagnostic procedures and repeated hospitalizations. Angiodysplasia is the commonest cause of obscure GI bleeding, particularly in the elderly. Inflammatory lesions and tumours are the usual causes of small intestinal bleeding in younger patients. Capsule endoscopy and deep enteroscopy have improved our ability to investigate small bowel bleeds. Deep enteroscopy has also an added advantage of therapeutic potential. Computed tomography is helpful in identifying extra-intestinal lesions. In cases of difficult diagnosis, surgery and intra-operative enteroscopy can help with diagnosis and management. The treatment is dependent upon the aetiology of the bleed. An overt bleed requires aggressive resuscitation and immediate localisation of the lesion for institution of appropriate therapy. Small bowel bleeding can be managed by conservative, radiological, pharmacological, endoscopic and surgical methods, depending upon indications, expertise and availability. Some patients, especially those with multiple vascular lesions, can re-bleed even after appropriate treatment and pose difficult challenge to the treating physician.

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Section: Management Of Small Bowel Bleedmentioning

confidence: 99%

Small bowel bleeding: a comprehensive review

Gunjan

Sharma

Bhasin

2014

Gastroenterology Report

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“…Radiation concern is an important issue in CTE because patients with Crohn disease are relatively younger and are expected to undergo multiple follow-up CT studies 35. Desmond et al36 reported that portion of CT scans contributing to cumulative effective dose increased from 46.3% during the first 5 years to 84.7% during the final 5 years in their 15-year study of patients with IBD.…”

Section: Cte Findings Of Intestinal Bdmentioning

confidence: 99%

Computed Tomography Enterography for Evaluation of Inflammatory Bowel Disease

Park

Lim

2013

Clin Endosc

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Computed tomography enterography (CTE) has become a main modality for the evaluation of inflammatory bowel disease (IBD). It simultaneously offers visualization of the small bowel and extraintestinal status, which is helpful for diagnosing IBD. Crohn disease has long segmental enhancing wall thickening related with the eccentric longitudinal distribution. In addition, mural stratification, fibrofatty proliferation, positive comb sign by increased mesenteric vascularity and internal/perianal fistula are characteristics of Crohn disease and can be identified on CTE. Short segmental inflammatory wall thickening and the central low attenuated lymph nodes are favorable CT finding of intestinal tuberculosis. A geographic, relatively large, and deep penetrating ulcer with bowel wall thickening and mural hyperenhancement in ileocecal area are characteristics of intestinal Behcet disease. Each of CTE findings for the IBDs is helpful for differential diagnosis. The main disadvantage of this technique is the requisite radiation exposure of patients, particularly in young patients. However, recent development of advanced CT techniques is promising for radiation dose reduction without compromising diagnostic image quality.

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“…CT enteroclysis promotes a more efficient intestinal distension, especially of the duodenum and jejunum. However, it is less accepted by patients owing to the need to pass an enteric tube for preparation (32) . Wold et al (33) found no difference in the quality of intestinal distension promoted by CT enteroclysis and CT enterography.…”

Section: Resultsmentioning

confidence: 99%

Comparative Analysis of Two Oral Contrast Agent Volumes for Computed Tomography Enterography in Crohn’s Disease Patients

Renosto

Barros

Bertoldi

et al. 2021

Arq. Gastroenterol.

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BACKGROUND: Crohn’s disease (CD) is an inflammatory bowel disease characterized by a chronic and recurrent inflammation of the gastrointestinal tract caused by an interaction of genetic and environmental factors. OBJECTIVE: To compare the quality and acceptance of two different oral contrast volumes for computed tomography enterography in Crohn’s disease patients. METHODS: A cross-sectional study was conducted in 58 consecutive Crohn’s disease patients who randomly received an oral contrast agent composed of 78.75 g polyethylene glycol diluted in either 1,000 mL or 2,000 mL of water. An examination was performed to evaluate the presence of inflammation or complications in the small bowel. The variables included the quality of intestinal segment filling and luminal distension, and oral contrast agent acceptance and tolerance in the patients. Statistical analysis included descriptive statistics and association tests. RESULTS: A total of 58 patients were assessed, in which 58.6% were female, 34.5% exhibited clinically-active disease, and 63.8% were receiving biologic therapy. As for comparative analysis between the two different volumes of oral contrast, no statistically significant difference was found regarding bowel loop filling (P=0.58) and adequate luminal distension (P=0.45). Patients who received a larger volume (2,000 mL) exhibited side-effects more frequently (51.7% vs 31.0%; P=0.06) and had greater difficulty ingesting the agent (65.5% vs 37.9%; P=0.07) compared with a volume of 1,000 mL. CONCLUSION: The quality of computed tomography enterography was not influenced by the contrast volume. However, acceptance and tolerance were better in the 1,000 mL group.

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CT enterography: state-of-the-art CT technique for small bowel imaging

Cited by 5 publications

References 30 publications

Small bowel bleeding: a comprehensive review

Small bowel bleeding: a comprehensive review

Computed Tomography Enterography for Evaluation of Inflammatory Bowel Disease

Comparative Analysis of Two Oral Contrast Agent Volumes for Computed Tomography Enterography in Crohn’s Disease Patients

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