However, new endoscopic developments—notably the recent introduction of capsule endoscopy and double balloon enteroscopy—are challenging this position. Brenner and Hall [ 55 ] predicted that 1. Multiphase CT enterography evaluation of small-bowel vascular lesions. Improved visualisation of lesions compared with conventional CT and fluoroscopy, enabling improved lesion-directed planning. The second part was a question to patients to list the three most unacceptable burdens of CTE. However, the radiation burden is approximately three times higher, and therefore potential radiation risks should be balanced against patient benefit.
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. Macari M, Balthazar EJ. Intestinal ischemia versus intramural hemorrhage: Axial CT enterography image showing two areas of focal small bowel spasm mimicking pathology arrows. 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. An effective and safe sedation technique combining target-controlled infusion pump with propofol, intravenous pentazocine, and bispectral index monitoring for peroral double-balloon endoscopy.
CT enterography: review of technique and practical tips
This article has been cited by other articles in PMC. Int J Clin Pract. J Natl Cancer Inst. Indications for detection, completion, and retention rates of small bowel capsule endoscopy based on the year data from the Korean Capsule Endoscopy Registry.
Table 7 Specific indications for CT enterography. Akin to CT colonography, optimising luminal distension will facilitate rapid and efficient luminal navigation, enabling accurate detection and characterisation of abnormalities. Intestinal ischemia versus intramural hemorrhage: All the DBE examinations were performed by the same endoscopist via the anal approach with conscious sedation injection of 10 mg diazepam intramuscularly before the procedure.
However, with increasingly robust MR enterography and ultrasound techniques available, it is the responsibility of radiologists and clinicians alike to ensure that cumulative radiation dose is strongly considered when selecting the optimal imaging modality for assessment of Crohn’s disease. In addition, capsule endoscopy may be superior to radiological tests for diagnosis of early Crohn’s disease and small bowel neoplasms.
CT enterography: review of technique and practical tips
Mural thickening and symmetry The site, degree and symmetry of mural thickening can also help in the characterisation of small bowel pathology. Table 8 lists the commoner small bowel tumours, and provides information on incidence and imaging characteristics. Clinical symptoms arise from complications of Meckel’s diverticulum, such as peptic ulceration with haemorrhage, diverticulitis, intestinal obstruction from diverticular inversion, volvulus, intussusception, inclusion of diverticulum in a hernia, formation of enteroliths and development of neoplasia within the diverticulum.
Homogeneous hyperenhancement is commonly seen with active Crohn’s disease, and is frequently associated with increased density in the surrounding mesenteric fat. National Center for Biotechnology InformationU.
Peroral CT enterography with lactulose solution: Note the prominent mucosal pattern in the proximal jejunal loops. In the non-distended loops, enterigraphy signs of disease must be used to diagnose pathological processes, including associated changes in the adjacent small bowel mesentery such as hypervascularity, fat stranding or lymphadenopathy. However, positive contrast can occasionally help establish fistula patency or the exact site of mechanical obstruction, because it will track the flow of luminal contents [ 16 ].
There are limited published data comparing CT enteroclysis and CT enterography, but quality of luminal distension and patient experience are vt considerations. From August 1,rnterography December 31,patients with suspected or known small bowel diseases who underwent both CTE and DBE via anal examinations were prospectively enrolled in our study in Ruijin Hospital.
Oral contrast agents for small bowel distension in MRI: Differential contrast enhancement of the bowel is a cardinal sign. Invasiveness to the bowel The six selectable options were discomfort of the bowel preparation, ingesting large amount of mannitol, radiation exposure, prolonged time duration of the test, high cost, and slow recovery of bowel function after the exam.
Imaging findings after radiotherapy to the pelvis. Published 16 October Volume Questionnaires One week after CTE, the thesia were asked to complete the first questionnaire Figure S1 composed of two parts.
Supine single phase images acquired at 50 s post-intravenous contrast administration. CTE, computed thessi enterography. The second part was a question to patients to list the three most unacceptable burdens of CTE. Exoenteric mass with adjacent lymphadenopathy and aneurysmal dilatation. 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.
Decreased enhancement is typical of bowel ischaemia [ 1623 – 25 ], and usually precedes the development of intramural gas and subsequent perforation. Axial CT enterography image showing a collapsed small bowel mimicking pathology long arrow compared with a normal fluid-filled loop short arrow. In small patients and patients with history of previous small bowel resection, smaller volumes of oral contrast may be sufficient, judged mainly by patient tolerance.