Such ulcers may penetrate through the wall, forming a small periluminal abscess indicating localised perforation. Automated 2-mm axial and coronal reformats generated and archived to picture archiving and communication system PACS. Radiation exposure Unlike MR enterography or capsule endoscopy, CT enterography utilises ionising radiation. Comparing CT enterography with other modalities CT enterography has several advantages over small bowel follow-through and conventional enteroclysis [ 1 , 15 ]. Radiological findings of Crohn’s disease at CT enterography include mucosal hyperenhancement, mural thickening and stratification, transmural ulceration, mesenteric inflammation, engorgement of vasa recta and strictures associated with upstream dilatation Figure 4.
The seven selectable options were discomfort of the bowel preparation, abdominal distension during the procedure, painfulness during the test, invasiveness to the bowel, prolonged duration of the test, high cost, and slow recovery of bowel function after the exam. Conspicuity of small bowel inflammation at CT enterography: This protocol would frequently include pre-contrast, arterial and delayed-phase CT examinations of the abdomen and pelvis. J Med Imaging Radiat Oncol. Author information Article notes Copyright and License information Disclaimer.
Polypoid or carpet-like with mesenteric desmoplastic reaction; may have calcified deposits in mesentery; may have hypervascular or necrotic liver metastases.
By accessing the work you hereby accept the Terms. Crohn’s disease, tuberculosis and neoplasms i. Exclusion criteria included allergies to contrast media previous adverse events during iodinated dt media injectionsevere small neterography stricture or obstruction, recent use of antiplatelet or anticoagulant drugs, pregnancy or breast-feeding, electrolyte disturbance, inability to understand or finish the questionnaires independently, other serious diseases. If utilised in higher-risk groups, consider reducing the volume of intravenous contrast, ensure patients are well hydrated before the examination and monitor renal function closely thess.
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.
CT enterography: review of technique and practical tips
Radiologic investigations complement and add diagnostic information to capsule endoscopy of small-bowel diseases. An effective and safe sedation technique combining target-controlled infusion pump with propofol, intravenous pentazocine, and bispectral index monitoring for peroral double-balloon endoscopy. 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 [ 162231 – 34 ].
Significant small-bowel lesions detected by alternative diagnostic modalities after negative capsule endoscopy. They were asked to fill out a questionnaire evaluating discomfort of the procedure after each examination. Note the prominent mucosal pattern in the proximal jejunal loops.
This work is published and licensed by Dove Medical Press Limited. Radiological Society of North America scientific assembly and annual meeting program. Improved visualisation of mucosal lesions compared with conventional CT. It is important to first distinguish abnormal from normal segments. Several authors have subsequently described similar techniques, which are broadly categorised into CT enterography where patients drink oral contrast and CT enteroclysis luminal contrast is introduced via a nasojejunal tube placed fluoroscopically prior to CT examination.
Comparison of adequacy of oral contrast bowel preparation with two different low attenuation agents for CT enterography CTE in patients with known or suspected inflammatory bowel disease. Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: Less sensitive than capsule study for detection of small mucosal lesions. Questionnaires used in our study comparing tolerance between computed tomography enterography and double-balloon enteroscopy.
Mucosa Submucosa Serosa Crohn’s disease, tuberculosis and neoplasms i. Gastroenterol Hepatol N Y. Gadolinium-based intravenous contrast used for MR examination enterograpby also be safer in adults than the iodinated contrast used for CT.
The main limitations of CTE are radiation exposure and inability of biopsy. Patients prefer propofol to midazolam plus fentanyl for sedation for colonoscopy: Multiphase CT enterography evaluation of small-bowel vascular lesions.
CT enterography: review of technique and practical tips
Outside the scanner room, patients are then encouraged to drink up to 2 l of oral contrast—2. In the authors’ experience, lack of portal venous phase imaging is rarely a problem for patients undergoing CT enterography because subtle liver metastases are rarely the target of imaging in this patient group.
Importantly, there are data suggesting that CT may be complimentary to capsule endoscopy.
For permission for commercial use of this work, please see paragraphs 4. Ionizing radiation exposure in patients with inflammatory bowel disease: Boudiaf et al classified small bowel distension using a grading system based on diameters of jejunum and ileum graded 0—3 where 0 was for no distension and 3 was optimal distension. The serosa is predominantly involved in metastases, endometriosis, carcinoid and other inflammatory conditions in the peritoneum.
Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. A list of common indications for CT enterography is given in Table 7.
Compared with MRI enterography, the authors of this article have found that CT enterography images frequently provide greater diagnostic confidence for exclusion of both small bowel and extraluminal pathology.