Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 10/2009

01-10-2009 | Gastrointestinal

Enteroclysis CT and PEG-CT in patients with previous small-bowel surgical resection for Crohn’s disease: CT findings and correlation with endoscopy

Authors: Laura Maria Minordi, Amorino Vecchioli, Giuliana Poloni, Luisa Guidi, Italo De Vitis, Lorenzo Bonomo

Published in: European Radiology | Issue 10/2009

Login to get access

Abstract

The aim of this study was to evaluate the accuracy of multidetector CT in patients with Crohn’s disease (CD) relapse after ileocolic resection compared with endoscopy. Thirty-four patients were studied by endoscopy and multidetector CT, after oral administration of polyethylene glycol solution (n = 21) or after administration of methylcellulose via nasojejunal tube (n = 13). In CT examinations we evaluated the presence of mural thickening, target sign, perienteric stranding, comb sign, fibrofatty proliferation and complications. Endoscopic results were classified in accordance with Rutgeerts score (from 0 to 4). The statistical evaluations were carried out by using Fisher’s exact text and χ 2 testing (p < 0.05, statistically significant difference). Sensitivity, specificity and accuracy of the CT were 96.9%, 100% and 97%, respectively. We found a statistically significant correlation between an endoscopic score of 4 and the CT signs of target sign, perienteric stranding, comb sign and fibrofatty proliferation, and between scores 1 and 2 and mucosal hyperdensity without or with mural thickening, respectively (p < 0.05). Moreover, only CT identified the presence of jejunal and proximal ileum disease in two and three patients, respectively, and fistulas in three patients. CT is a reliable method in the diagnosis of CD relapse and shows agreement with the approved endoscopic Rutgeerts score.
Literature
1.
Rutgeerts P, Geboes K, Vantrappen G et al (1984) Natural history of recurrent Crohn’s disease at the ileocolonic anastomosis after curative surgery. Gut 25:665–672PubMedCrossRef
2.
Rutgeerts P, Geboes K, Vantrappen G et al (1990) Predictability of the postoperative course of Crohn’s disease. Gastroenterology 99:956–963PubMed
3.
Pons Beltrán V, Nos P, Bastida G et al (2007) Evaluation of postsurgical recurrence in Crohn’s disease: a new indication for capsule endoscopy? Gastrointest Endosc 66:533–540PubMedCrossRef
4.
Andreoli A, Cerro P, Falasco G et al (1998) Role of ultrasonography in the diagnosis of postsurgical recurrence of Crohn’s disease. Am J Gastroenterol 93:1117–1121PubMedCrossRef
5.
Bourreille A, Jarry M, D’Halluin PN et al (2006) Wireless capsule endoscopy versus ileocolonoscopy for the diagnosis of postoperative recurrence of Crohn’s disease: a prospective study. Gut 55:978–983PubMedCrossRef
6.
Zalev AH, Deitel W, Kundu S et al (2005) Radiologic appearance of recurrent ileal Crohn disease. Abdom Imaging 30:665–70PubMedCrossRef
7.
Sailer J, Peloschek P, Reinisch W et al (2008) Anastomotic recurrence of Crohn’s disease after ileocolic resection: comparison of MR enteroclysis with endoscopy. Eur Radiol 18:2512–21PubMedCrossRef
8.
Balthazar EJ (2002) In: Gourtsoyiannis NC (ed) Evaluation of the small intestine by computed tomography. Radiological imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 87–130
9.
Kelvin FM, Herlinger H (1999) Crohn’s disease. In: Herlinger H, Maglinte DDT, Birnbaum BA (eds) Clinical imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 259–289
10.
11.
Bender GN, Maglinte DD, Klöppel VR et al (1999) CT enteroclysis: a superfluous diagnostic procedure or valuable when investigating small bowel disease? AJR 172:373–378PubMed
12.
Minordi LM, Vecchioli A, Guidi L et al (2006) Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease. Eur Radiol 16:1527–1536PubMedCrossRef
13.
Minordi LM, Vecchioli A, Poloni G et al (2007) CT enteroclysis: multidetector technique (MDCT) versus single-detector technique (SDCT) in patients with suspected small-bowel Crohn’s disease. Radiol Med 112:1188–1200PubMedCrossRef
14.
Minordi LM, Vecchioli A, Mirk P et al (2007) Multidetector CT in small-bowel neoplasms. Radiol Med 112:1013–1025PubMedCrossRef
15.
Rollandi GA, Curone PF, Biscaldi E et al (1999) Spiral CT of the abdomen after distention of small bowel loops with transparent enema in patient with Crohn’s disease. Abdom Imaging 24:544–549PubMedCrossRef
16.
Laghi A, Paolantonio P, Iafrate F et al (2003) MR of the small bowel with a biphasic oral contrast agent (polyethylene glycol): technical aspects and findings in patients affected by Crohn’s disease. Radiol Med 106:18–27PubMed
17.
Magnano G, Granata C, Barabino A et al (2003) Polyethylene glycol and contrast-enhanced MRI of Crohn’s disease in children: preliminary experience. Pediatr Radiol 33:385–391PubMed
18.
Mazzeo S, Caramella D, Belcari A et al (2005) Multidetector CT of the small bowel: evaluation after oral hyperhydration with isotonic solution. Radiol Med 109:516–526PubMed
Metadata
Title
Enteroclysis CT and PEG-CT in patients with previous small-bowel surgical resection for Crohn’s disease: CT findings and correlation with endoscopy
Authors
Laura Maria Minordi
Amorino Vecchioli
Giuliana Poloni
Luisa Guidi
Italo De Vitis
Lorenzo Bonomo
Publication date
01-10-2009
Publisher
Springer-Verlag
Published in
European Radiology / Issue 10/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1423-5

Other articles of this Issue 10/2009

European Radiology 10/2009 Go to the issue

Hepatobiliary-Pancreas

The role of arterial stimulation and simultaneous venous sampling in addition to cross-sectional imaging for localisation of biochemically proven insulinoma

Chest

Fully automatic quantitative assessment of emphysema in computed tomography: comparison with pulmonary function testing and normal values

Opinion

The evolving radiology landscape: the importance of effective leadership

Breast

Sonographic correlations with the new molecular classification of invasive breast cancer

Gastrointestinal

A hand-held ultrasound machine vs. conventional ultrasound machine in the bedside assessment of post-liver transplant patients

Interventional

Polidocanol sclerotherapy for painful venous malformations: evaluation of safety and efficacy in pain relief