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Published in: Abdominal Radiology 3/2012

01-06-2012

Small intestinal tumors: diagnostic accuracy of enhanced multi-detector CT virtual endoscopy

Authors: Xuejuan Su, Yinghui Ge, Baosong Liang, Minghui Wu, Ying Guo, Bo Ma, Jianying Li

Published in: Abdominal Radiology | Issue 3/2012

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Abstract

Objective

To study the diagnostic accuracy of enhanced multi-detector CT virtual endoscopy (MDCT-VE) for small intestinal tumors.

Materials and methods

125 patients were examined by multi-detector CT (MDCT: 54 on 4-slice; 71 on 64-slice) following standard gastrointestinal tract cleansing, oral double contrast aerogenesis agent, and rectal gas administration. Unenhanced CT was performed, followed by enhanced CT in supine (30 and 80s delay after 100 mL standard intravenous contrast medium) and prone positions (180s delay). Supplementary CT in the lateral position was performed if small bowel was not well-filled. Images were reviewed on post-processing workstations with Virtual Endoscopy software.

Results

33/125 patients had proven small intestinal tumors: ten stromal tumors, nine lymphoma, eight adenocarcinomas, three hemangiomas, one each lipoma, Brunner gland adenoma, and hamartoma. 92 were nontumors. MDCT-VE correctly identified 30/33 cases with one false-positive diagnosis: sensitivity 90.9%, specificity 98.9% and accuracy 96.8%.

Conclusion

Small intestinal MDCT-VE technique has high diagnostic accuracy for the detection of intestinal tumors. Contrast enhancement and adequate intestinal tract gas-filling can improve the detection rate for small intestinal tumors.
Literature
1.
go back to reference Romano S, De Lutio E, Rollandi GA, et al. (2005) Multidetector computed tomography enteroclysis (MDCT-E) with neutral enteral and IV contrast enhancement in tumour detection. Eur Radiol 15:1178–1183PubMedCrossRef Romano S, De Lutio E, Rollandi GA, et al. (2005) Multidetector computed tomography enteroclysis (MDCT-E) with neutral enteral and IV contrast enhancement in tumour detection. Eur Radiol 15:1178–1183PubMedCrossRef
2.
3.
go back to reference Masselli G, Polettini E, Casciani E, et al. (2009) Small-bowel neoplasms: prospective evaluation of MR enteroclysis. Radiology 251:743–750PubMedCrossRef Masselli G, Polettini E, Casciani E, et al. (2009) Small-bowel neoplasms: prospective evaluation of MR enteroclysis. Radiology 251:743–750PubMedCrossRef
4.
go back to reference Van Weyenberg SJ, Meijerink MR, Jacobs MA, et al. (2010) MR enteroclysis in the diagnosis of small-bowel neoplasms. Radiology 254:765–773PubMedCrossRef Van Weyenberg SJ, Meijerink MR, Jacobs MA, et al. (2010) MR enteroclysis in the diagnosis of small-bowel neoplasms. Radiology 254:765–773PubMedCrossRef
5.
go back to reference 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 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
6.
go back to reference Delabrousse E, Destrumelle N, Brunelle S, et al. (2003) CT of small bowel obstruction in adults. Abdom Imaging 28:257–266PubMedCrossRef Delabrousse E, Destrumelle N, Brunelle S, et al. (2003) CT of small bowel obstruction in adults. Abdom Imaging 28:257–266PubMedCrossRef
7.
go back to reference Reittner P, Goritschnig T, Petritsch W, et al. (2002) Multiplanar spiral CT enterography in patients with Crohn’s disease using a negative oral contrast material: initial results of a noninvasive imaging approach. Eur Radiol 12:2253–2257PubMed Reittner P, Goritschnig T, Petritsch W, et al. (2002) Multiplanar spiral CT enterography in patients with Crohn’s disease using a negative oral contrast material: initial results of a noninvasive imaging approach. Eur Radiol 12:2253–2257PubMed
8.
go back to reference Rajesh A, Maglinte DD (2006) Multislice CT enteroclysis: technique and clinical applications. Clin Radiol 61:31–39PubMedCrossRef Rajesh A, Maglinte DD (2006) Multislice CT enteroclysis: technique and clinical applications. Clin Radiol 61:31–39PubMedCrossRef
9.
go back to reference Schmidt S, Felley C, Meuwly JY, Schnyder P, Denys A (2006) CT enteroclysis: technique and clinical applications. Eur Radiol 16:648–660PubMedCrossRef Schmidt S, Felley C, Meuwly JY, Schnyder P, Denys A (2006) CT enteroclysis: technique and clinical applications. Eur Radiol 16:648–660PubMedCrossRef
10.
go back to reference Maglinte DD, Sandrasegaran K, Lappas JC (2007) CT enteroclysis: techniques and applications. Radiol Clin North Am 45:289–301PubMedCrossRef Maglinte DD, Sandrasegaran K, Lappas JC (2007) CT enteroclysis: techniques and applications. Radiol Clin North Am 45:289–301PubMedCrossRef
11.
go back to reference Doerfler OC, Ruppert-Kohlmayr AJ, Reittner P, et al. (2003) Helical CT of the small bowel with an alternative oral contrast material in patients with Crohn disease. Abdom Imaging 28:313–318PubMedCrossRef Doerfler OC, Ruppert-Kohlmayr AJ, Reittner P, et al. (2003) Helical CT of the small bowel with an alternative oral contrast material in patients with Crohn disease. Abdom Imaging 28:313–318PubMedCrossRef
12.
go back to reference Ramsay DW, Markham DH, Morgan B, Rodgers PM, Liddicoat AJ (2001) The use of dilute Calogen as a fat density oral contrast medium in upper abdominal computed tomography, compared with the use of water and positive oral contrast media. Clin Radiol 56:670–673PubMedCrossRef Ramsay DW, Markham DH, Morgan B, Rodgers PM, Liddicoat AJ (2001) The use of dilute Calogen as a fat density oral contrast medium in upper abdominal computed tomography, compared with the use of water and positive oral contrast media. Clin Radiol 56:670–673PubMedCrossRef
13.
go back to reference Zhang LH, Zhang SZ, Hu HJ, et al. (2005) Multi-detector CT enterography with iso-osmotic mannitol as oral contrast for detecting small bowel disease. World J Gastroenterol 11:2324–2329PubMed Zhang LH, Zhang SZ, Hu HJ, et al. (2005) Multi-detector CT enterography with iso-osmotic mannitol as oral contrast for detecting small bowel disease. World J Gastroenterol 11:2324–2329PubMed
14.
go back to reference Thompson SE, Raptopoulos V, Sheiman RL, McNicholas MM, Prassopoulos P (1999) Abdominal helical CT: milk as a low-attenuation oral contrast agent. Radiology 211:870–875PubMed Thompson SE, Raptopoulos V, Sheiman RL, McNicholas MM, Prassopoulos P (1999) Abdominal helical CT: milk as a low-attenuation oral contrast agent. Radiology 211:870–875PubMed
15.
go back to reference Koo CW, Shah-Patel LR, Baer JW, Frager DH (2008) Cost-effectiveness and patient tolerance of low-attenuation oral contrast material: milk versus VoLumen. AJR Am J Roentgenol 190:1307–1313PubMedCrossRef Koo CW, Shah-Patel LR, Baer JW, Frager DH (2008) Cost-effectiveness and patient tolerance of low-attenuation oral contrast material: milk versus VoLumen. AJR Am J Roentgenol 190:1307–1313PubMedCrossRef
16.
go back to reference Horton KM, Eng J, Fishman EK (2000) Normal enhancement of the small bowel: evaluation with spiral CT. J Compute Assist Tomogr 24:67–71CrossRef Horton KM, Eng J, Fishman EK (2000) Normal enhancement of the small bowel: evaluation with spiral CT. J Compute Assist Tomogr 24:67–71CrossRef
17.
go back to reference Luboldt W, Fletcher JG, Vogl TJ (2002) Colonography: current status, research directions and challenges. Update 2002. Eur Radiol 12:504–524 Luboldt W, Fletcher JG, Vogl TJ (2002) Colonography: current status, research directions and challenges. Update 2002. Eur Radiol 12:504–524
18.
go back to reference Landeras LA, Aslam R, Yee J (2007) Virtual colonoscopy: technique and accuracy. Radiol Clin North Am 45:333–345PubMedCrossRef Landeras LA, Aslam R, Yee J (2007) Virtual colonoscopy: technique and accuracy. Radiol Clin North Am 45:333–345PubMedCrossRef
19.
go back to reference Rogalla P, Werner-Rustner M, Huitema A, et al. (1998) Virtual endoscopy of the small bowel: phantom study and preliminary clinical results. Eur Radiol 8:563–567PubMedCrossRef Rogalla P, Werner-Rustner M, Huitema A, et al. (1998) Virtual endoscopy of the small bowel: phantom study and preliminary clinical results. Eur Radiol 8:563–567PubMedCrossRef
20.
go back to reference Endo K, Utano K, Togashi K, et al. (2010) Virtual enteroscopy using air as the contrast material: a preliminary feasibility study. Dig Endosc 22:205–210PubMedCrossRef Endo K, Utano K, Togashi K, et al. (2010) Virtual enteroscopy using air as the contrast material: a preliminary feasibility study. Dig Endosc 22:205–210PubMedCrossRef
21.
go back to reference Boudiaf M, Jaff A, Soyer P, et al. (2004) Small-bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients. Radiology 233:338–344PubMedCrossRef Boudiaf M, Jaff A, Soyer P, et al. (2004) Small-bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients. Radiology 233:338–344PubMedCrossRef
22.
go back to reference Maglinte DD, Sandrasegaran K, Lappas JC, Chiorean M (2007) CT Enteroclysis. Radiology 245:661–671PubMedCrossRef Maglinte DD, Sandrasegaran K, Lappas JC, Chiorean M (2007) CT Enteroclysis. Radiology 245:661–671PubMedCrossRef
23.
go back to reference Yamamoto H, Kita H, Sunada K, et al. (2004) Clinical outcomes of double-balloon enteroscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol 2:1010–1016PubMedCrossRef Yamamoto H, Kita H, Sunada K, et al. (2004) Clinical outcomes of double-balloon enteroscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol 2:1010–1016PubMedCrossRef
24.
go back to reference Jonnalagdda S, Prakash C (2003) Intestinal Strictures can impede wireless capsule enteroscopy. Gastrointest Endosc 57:418–420CrossRef Jonnalagdda S, Prakash C (2003) Intestinal Strictures can impede wireless capsule enteroscopy. Gastrointest Endosc 57:418–420CrossRef
25.
go back to reference Umschaden HW, Szolar D, Gasser J, Umschaden M, Haselbach H (2000) Small-bowel disease comparison of MR enteroclysis images with conventional enteroclysis and surgical findings. Radiology 215:717–725PubMed Umschaden HW, Szolar D, Gasser J, Umschaden M, Haselbach H (2000) Small-bowel disease comparison of MR enteroclysis images with conventional enteroclysis and surgical findings. Radiology 215:717–725PubMed
26.
go back to reference Schmidt S, Lepori D, Meuwly JY, et al. (2003) Prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis: interobserver agreement and sensitivity by means of “sign-by-sign” correlation. Eur Radiol 13:1303–1311PubMed Schmidt S, Lepori D, Meuwly JY, et al. (2003) Prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis: interobserver agreement and sensitivity by means of “sign-by-sign” correlation. Eur Radiol 13:1303–1311PubMed
27.
go back to reference Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, et al. (2004) Assessment of Crohn’s disease activity in the small bowel with MR and conventional enteroclysis: preliminary results. Eur Radiol 14:1017–1024PubMedCrossRef Gourtsoyiannis N, Papanikolaou N, Grammatikakis J, et al. (2004) Assessment of Crohn’s disease activity in the small bowel with MR and conventional enteroclysis: preliminary results. Eur Radiol 14:1017–1024PubMedCrossRef
28.
go back to reference Wiarda BM, Kuipers EJ, Houdijk LP, Tuynman HA (2005) MR enteroclysis: imaging technique of choice in diagnosis of small bowel diseases. Dig Dis Sci 50:1036–1040PubMedCrossRef Wiarda BM, Kuipers EJ, Houdijk LP, Tuynman HA (2005) MR enteroclysis: imaging technique of choice in diagnosis of small bowel diseases. Dig Dis Sci 50:1036–1040PubMedCrossRef
29.
go back to reference Gölder SK, Schreyer AG, Endlicher E, et al. (2006) Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease. Int J Colorectal Dis 21:97–104PubMedCrossRef Gölder SK, Schreyer AG, Endlicher E, et al. (2006) Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease. Int J Colorectal Dis 21:97–104PubMedCrossRef
30.
go back to reference Torkzad MR, Vargas R, Tanaka C, Blomqvist L (2007) Value of cine MRI for better visualization of the proximal small bowel in normal individuals. Eur Radiol 17:2964–2968PubMedCrossRef Torkzad MR, Vargas R, Tanaka C, Blomqvist L (2007) Value of cine MRI for better visualization of the proximal small bowel in normal individuals. Eur Radiol 17:2964–2968PubMedCrossRef
31.
go back to reference Buhmann-Kirchhoff S, Lang R, Kirchhoff C, et al. (2008) Functional cine MR imaging for the detection and mapping of intraabdominal adhesions: method and surgical correlation. Eur Radiol 18:1215–1223PubMedCrossRef Buhmann-Kirchhoff S, Lang R, Kirchhoff C, et al. (2008) Functional cine MR imaging for the detection and mapping of intraabdominal adhesions: method and surgical correlation. Eur Radiol 18:1215–1223PubMedCrossRef
32.
go back to reference Castiglione F, Rispo A, Cozzolino A, et al. (2007) Bowel sonography in adult celiac disease: diagnostic accuracy and ultrasonographic features. Abdom Imaging 32:73–77PubMedCrossRef Castiglione F, Rispo A, Cozzolino A, et al. (2007) Bowel sonography in adult celiac disease: diagnostic accuracy and ultrasonographic features. Abdom Imaging 32:73–77PubMedCrossRef
33.
go back to reference Maconi G, Radice E, Greco S, Bezzio C, Bianchi Porro G (2007) Transient small-bowel intussusceptions in adults: significance of ultrasonographic detection. Clin Radiol 62:792–797PubMedCrossRef Maconi G, Radice E, Greco S, Bezzio C, Bianchi Porro G (2007) Transient small-bowel intussusceptions in adults: significance of ultrasonographic detection. Clin Radiol 62:792–797PubMedCrossRef
34.
go back to reference Bozkurt T, Richter F, Lux G (1994) Ultrasonography as a primary diagnostic tool in patients with inflammatory disease and tumours of the small intestine and large bowel. J Clin Ultrasound 22:85–91PubMedCrossRef Bozkurt T, Richter F, Lux G (1994) Ultrasonography as a primary diagnostic tool in patients with inflammatory disease and tumours of the small intestine and large bowel. J Clin Ultrasound 22:85–91PubMedCrossRef
35.
go back to reference Odegaard S, Nesje LB, Hausken T, et al. (2000) Intraluminal sonography in the diagnosis of gastrointestinal diseases. Ultraschall Med 21:47–58PubMedCrossRef Odegaard S, Nesje LB, Hausken T, et al. (2000) Intraluminal sonography in the diagnosis of gastrointestinal diseases. Ultraschall Med 21:47–58PubMedCrossRef
36.
go back to reference Nylund K, Ødegaard S, Hausken T, et al. (2009) Sonography of the small intestine. World J Gastroenterol 15:1319–1330PubMedCrossRef Nylund K, Ødegaard S, Hausken T, et al. (2009) Sonography of the small intestine. World J Gastroenterol 15:1319–1330PubMedCrossRef
37.
go back to reference Blay JY, Bonvalot S, Casali P, et al. (2005) Demetri GD; GIST consensus meeting panelists. Consensus meeting for the management of gastrointestinal stromal tumours. Report of the GIST Consensus Conference of 20–21 March 2004, under the Auspices of ESMO. Ann Oncol 16:566–578PubMedCrossRef Blay JY, Bonvalot S, Casali P, et al. (2005) Demetri GD; GIST consensus meeting panelists. Consensus meeting for the management of gastrointestinal stromal tumours. Report of the GIST Consensus Conference of 20–21 March 2004, under the Auspices of ESMO. Ann Oncol 16:566–578PubMedCrossRef
38.
go back to reference Hebert JJ, Taylor AJ, Winter TC, Reichelderfer M, Weichert JP (2006) Low-attenuation oral GI contrast agents in abdominal-pelvic computed tomography. Abdom Imaging 31:48–53PubMedCrossRef Hebert JJ, Taylor AJ, Winter TC, Reichelderfer M, Weichert JP (2006) Low-attenuation oral GI contrast agents in abdominal-pelvic computed tomography. Abdom Imaging 31:48–53PubMedCrossRef
Metadata
Title
Small intestinal tumors: diagnostic accuracy of enhanced multi-detector CT virtual endoscopy
Authors
Xuejuan Su
Yinghui Ge
Baosong Liang
Minghui Wu
Ying Guo
Bo Ma
Jianying Li
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Abdominal Radiology / Issue 3/2012
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-011-9776-z

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