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Published in: European Radiology 7/2006

01-07-2006 | Gastrointestinal

Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease

Authors: Laura Maria Minordi, Amorino Vecchioli, Luisa Guidi, Paoletta Mirk, Luisa Fiorentini, Lorenzo Bonomo

Published in: European Radiology | Issue 7/2006

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Abstract

The purpose of this study was to evaluate the diagnostic accuracy of multidetector-CT enteroclysis (MDCT-E) versus barium enteroclysis with methylcellulose (BE) in clinically selected patients with suspected small bowel disease. We prospectively studied 52 patients who underwent unenhanced and contrast-enhanced multidetector CT (16 rows) after administration of 2–2.5 l of methylcellulose by naso-jejunal tube. BE was performed after administration of barium 60% w/v (200–250 ml) and methylcellulose (1–2 l). Patients with radiological signs of Crohn’s disease were classified into the following subtypes: active, fibrostenotic, fistulising/perforating, reparative or regenerative subtypes. Twenty-eight patients also underwent endoscopy. The radiological prevalent subtype was the active subtype. The sensitivity, specificity and diagnostic accuracy of MDCT-E versus BE was 83%, 100% and 89%, respectively. BE showed five false negative CT cases due to early Crohn’s disease; endoscopy confirmed positive cases of the CT and the BE, but showed one false negative case of the BE. Together, MDCT enteroclysis and BE permitted the diagnosis of Crohn’s disease in 30 patients, adhesions in one patient, lymphoma in two patients and carcinoid tumours in two patients. In conclusion, MDCT-E permits good representation of pathological patterns. Early stages of Crohn’s disease are better evaluated by BE.
Literature
1.
go back to reference Birnbaum BA (1999) Computed tomography of the small bowel. Technique and principles of interpretation. In: Herlinger H, Maglinte DDT, Birnbaum BA (eds) Clinical imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 153–166 Birnbaum BA (1999) Computed tomography of the small bowel. Technique and principles of interpretation. In: Herlinger H, Maglinte DDT, Birnbaum BA (eds) Clinical imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 153–166
2.
go back to reference Bender GN, Timmons JH, Williard WC, Carter J (1996) Computed tomographic enteroclysis: one methodology. Invest Radiol 31:43–49CrossRefPubMed Bender GN, Timmons JH, Williard WC, Carter J (1996) Computed tomographic enteroclysis: one methodology. Invest Radiol 31:43–49CrossRefPubMed
3.
go back to reference Maglinte DD, Gourtsoyiannis N, Rex D, Howard TJ, Kelvin FM (2003) Classification of small bowel Crohn’s subtypes based on multimodality imaging. Radiol Clin North Am 41:285–303CrossRefPubMed Maglinte DD, Gourtsoyiannis N, Rex D, Howard TJ, Kelvin FM (2003) Classification of small bowel Crohn’s subtypes based on multimodality imaging. Radiol Clin North Am 41:285–303CrossRefPubMed
4.
go back to reference Liangpunsakul S, Chadalawada V, Rex DK, Maglinte D, Lappas J (2003) Wireless capsule endoscopy detects small bowel ulcers in patients with normal results from state of the art enteroclysis. Am J Gastroenterol 98:1295–1298CrossRefPubMed Liangpunsakul S, Chadalawada V, Rex DK, Maglinte D, Lappas J (2003) Wireless capsule endoscopy detects small bowel ulcers in patients with normal results from state of the art enteroclysis. Am J Gastroenterol 98:1295–1298CrossRefPubMed
5.
go back to reference Hara AK, Leighton JA, Sharma VK, Fleisher DE (2004) Small bowel: preliminary comparison of capsule endoscopy with barium study and CT. Radiology 230:260–265PubMedCrossRef Hara AK, Leighton JA, Sharma VK, Fleisher DE (2004) Small bowel: preliminary comparison of capsule endoscopy with barium study and CT. Radiology 230:260–265PubMedCrossRef
6.
go back to reference Maglinte DDT, Hallett RL, Rex D (2001) Imaging of small bowel Crohn’s disease: can abdominal CT replace barium radiography? Emerg Radiol 8:127–133CrossRef Maglinte DDT, Hallett RL, Rex D (2001) Imaging of small bowel Crohn’s disease: can abdominal CT replace barium radiography? Emerg Radiol 8:127–133CrossRef
7.
go back to reference Klöppel R, Thiele J, Bosse J (1992) The Sellink CT method. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 156:291–292PubMedCrossRef Klöppel R, Thiele J, Bosse J (1992) The Sellink CT method. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 156:291–292PubMedCrossRef
8.
go back to reference Scholten ET, Ziedses des Plantes BG, Falke TH (1995) Computed tomography of the large bowel wall. Choice of slice thickness and intraluminal contrast medium. Invest Radiol 5:275–284CrossRef Scholten ET, Ziedses des Plantes BG, Falke TH (1995) Computed tomography of the large bowel wall. Choice of slice thickness and intraluminal contrast medium. Invest Radiol 5:275–284CrossRef
9.
go back to reference Rollandi GA, Curone PF, Biscaldi E, Nardi F, Bonifacino E, Conzi R, Derchi LE (1999) Spiral CT of the abdomen after distension of small bowel loops with transparent enema in patients with Crohn’s disease. Abdom Imaging 24:544–549PubMedCrossRef Rollandi GA, Curone PF, Biscaldi E, Nardi F, Bonifacino E, Conzi R, Derchi LE (1999) Spiral CT of the abdomen after distension of small bowel loops with transparent enema in patients with Crohn’s disease. Abdom Imaging 24:544–549PubMedCrossRef
10.
go back to reference Turetschek K, Schober E, Wunderbaldinger P, Bernhard C, Schima W, Puespoek A, Vogelsang H, Moeschl P, Mostbeck G (2002) Findings at helical CT enteroclysis in symptomatic patients with Crohn disease: correlation with endoscopic and surgical findings. J Comput Assist Tomogr 26:488–492 CrossRefPubMed Turetschek K, Schober E, Wunderbaldinger P, Bernhard C, Schima W, Puespoek A, Vogelsang H, Moeschl P, Mostbeck G (2002) Findings at helical CT enteroclysis in symptomatic patients with Crohn disease: correlation with endoscopic and surgical findings. J Comput Assist Tomogr 26:488–492 CrossRefPubMed
11.
go back to reference Wold PB, Fletcher JG, Johnson CD, Sandborn WJ (2003) Assessment of small bowel Crohn disease: noninvasive peroral CT enterography compared with other imaging methods and endoscopy-feasibility study. Radiology 229:275–281PubMedCrossRef Wold PB, Fletcher JG, Johnson CD, Sandborn WJ (2003) Assessment of small bowel Crohn disease: noninvasive peroral CT enterography compared with other imaging methods and endoscopy-feasibility study. Radiology 229:275–281PubMedCrossRef
12.
go back to reference Makò EK, Mester AR, Tarjan Z, Karlinger K, Toth G (2000) Enteroclysis and spiral CT examination in diagnosis and evaluation of small bowel Crohn’s disease. Eur J Radiol 35:168–175PubMedCrossRef Makò EK, Mester AR, Tarjan Z, Karlinger K, Toth G (2000) Enteroclysis and spiral CT examination in diagnosis and evaluation of small bowel Crohn’s disease. Eur J Radiol 35:168–175PubMedCrossRef
13.
go back to reference Rust GF, Sackman M, Eisele O, Reiser M (2001) Virtual large intestine imaging with multi-level CT. Pain free coloscopy that works! MMW Fortschr Med 143:32–36PubMed Rust GF, Sackman M, Eisele O, Reiser M (2001) Virtual large intestine imaging with multi-level CT. Pain free coloscopy that works! MMW Fortschr Med 143:32–36PubMed
14.
go back to reference Balthazar EJ (2002) Evaluation of the small intestine by computed tomography. In: Gourtsoyiannis NC (ed) Radiological imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 87–130 Balthazar EJ (2002) Evaluation of the small intestine by computed tomography. In: Gourtsoyiannis NC (ed) Radiological imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 87–130
15.
go back to reference Horton KM, Eng J, Fishman EK (2000) Normal enhancement of the small bowel: evaluation with spiral CT. J Comput Assist Tomogr 24:67–71CrossRefPubMed Horton KM, Eng J, Fishman EK (2000) Normal enhancement of the small bowel: evaluation with spiral CT. J Comput Assist Tomogr 24:67–71CrossRefPubMed
16.
go back to reference Maglinte DD, Lappas JC, Heitkamp DE, Bender GN, Kelvin FM (2003) Technical refinements in enteroclysis. Radiol Clin North Am 41:213–229PubMedCrossRef Maglinte DD, Lappas JC, Heitkamp DE, Bender GN, Kelvin FM (2003) Technical refinements in enteroclysis. Radiol Clin North Am 41:213–229PubMedCrossRef
17.
go back to reference 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 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
18.
go back to reference Horton KM, Fishamn EK (2003) The current status of multidetector row CT and three-dimensional imaging of the small bowel. Radiol Clin North Am 41:199–212PubMedCrossRef Horton KM, Fishamn EK (2003) The current status of multidetector row CT and three-dimensional imaging of the small bowel. Radiol Clin North Am 41:199–212PubMedCrossRef
19.
go back to reference Raptopoulos V, Schwatz RK, McNicholas MM, Movson J, Pearlman J, Joffe N (1997) Multiplanar helical CT enterography in patients with Crohn’s disease. AJR Am J Roentgenol 169:1545–1550PubMed Raptopoulos V, Schwatz RK, McNicholas MM, Movson J, Pearlman J, Joffe N (1997) Multiplanar helical CT enterography in patients with Crohn’s disease. AJR Am J Roentgenol 169:1545–1550PubMed
20.
go back to reference Schmidt S, Chevallier P, Charalon M, Bessoud B, Verdun FR, Frascarolo P, Schnyder P, Denys A (2005) Multidetector CT enteroclysis: comparison of the reading performance for axial and coronal views. Eur Radiol 15:238–246PubMedCrossRef Schmidt S, Chevallier P, Charalon M, Bessoud B, Verdun FR, Frascarolo P, Schnyder P, Denys A (2005) Multidetector CT enteroclysis: comparison of the reading performance for axial and coronal views. Eur Radiol 15:238–246PubMedCrossRef
21.
go back to reference Romano S, De Lutio E, Rollandi GA, Romano L, Grassi R, Maglinte DD (2005) Multidetector computer tomography enteroclysis (MDCT-E) with neutral enteral and IV contrast enhancement in tumor detection. Eur Radiol 15:1178–1183CrossRefPubMed Romano S, De Lutio E, Rollandi GA, Romano L, Grassi R, Maglinte DD (2005) Multidetector computer tomography enteroclysis (MDCT-E) with neutral enteral and IV contrast enhancement in tumor detection. Eur Radiol 15:1178–1183CrossRefPubMed
Metadata
Title
Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease
Authors
Laura Maria Minordi
Amorino Vecchioli
Luisa Guidi
Paoletta Mirk
Luisa Fiorentini
Lorenzo Bonomo
Publication date
01-07-2006
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2006
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-006-0185-6

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