Small-Bowel Diseases: Prospective Evaluation of Multi-Detector Row Helical CT Enteroclysis in 107 Consecutive Patients
Radiology 2004; 233:338-344.
Boudiaf M, Jaff A, Soyer P, Bouhnik Y, Hamzi L, Rymer R.
PURPOSE: To prospectively evaluate multi-detector row helical computed tomo-graphic (CT) enteroclysis for the depiction of small-bowel diseases.
MATERIALS AND METHODS: The study group included 107 patients who were suspected of having small-bowel tumor (n = 8), active inflammatory small-bowel disease (n = 18), unexplained gastrointestinal bleeding (n = 36), refractory celiac sprue (n = 14), and low-grade small-bowel obstruction (n — 31). A nasoenteric tube was positioned into the duodenojejunal junction by using fluoroscopic guidance and water was infused with a pressure-controlled pump. After intravenous administration of 120 mL of iodinated contrast material, multi-detector row helical CT enteroclysis images were obtained with 4 x 2.5 mm collimation (four detector rows and 2.5-mm section thickness). Multi-detector row helical CT enteroclysis findings were analyzed by two readers working in consensus. Findings were compared with the results of endoscopy, enteroscopy, videocapsule endoscopy, histopathologic analysis, or clinical follow-up.
RESULTS: Multi-detector row helical CT enteroclysis was well tolerated in 106 patients; one patient complained of abdominal pain after the examination. Multi-detector row helical CT enteroclysis allowed the diagnosis of small-bowel masses (n = 21), active Crohn disease (n - 9), small-bowel tuberculosis (n - 2), small-bowel lymphoma complicating celiac disease (n - 4), and confirmed low-grade small-bowel obstruction (n - 12). Multi-detector row helical CT enteroclysis demonstrated normal findings in 60 patients. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of multi-detector row helical CT enteroclysis were 100%, 95%, 97%, 94%, and 100%, respectively.
CONCLUSION: Multi-detector row helical CT enteroclysis allows depiction of small-bowel diseases in patients suspected of having small-bowel conditions.