CT enteroclysis: technique and clinical applications

Schmidt, Sabine; Felley, Christian; Meuwly, Jean‐Yves; Schnyder, P.; Denys, Alban

doi:10.1007/s00330-005-0005-4

Cited by 53 publications

(42 citation statements)

References 63 publications

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“…Taking into account that in this patient population enteroclysis stands at the end of the diagnostic chain these are satisfactory results which are consistent with the data of other research groups and justify the use of enteroclysis [24][25][26][27] . None the less investigation of gastrointestinal bleeding remains the domain of endoscopy.…”

Section: Discussionsupporting

confidence: 88%

“…Magnetic resonance imaging (MRI), therefore, is gaining importance by providing direct visualization of mural and extramural changes as well as utilizing multiplanar imaging [2] . Because of the superior soft tissue contrast MRI imaging is superior to computed tomography (CT) concerning enteral pathologies [2,24] . In addition, the absence of radiation exposure, especially among young and very young patients who have to undergo multiple follow-ups for chronic disease monitoring, is of high value.…”

Section: Discussionmentioning

confidence: 99%

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Enteroclysis: Current clinical value

Maataoui

Vogl²,

Jacobi³

et al. 2013

WJR

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AIM:To retrospectively analyze changes in clinical indication, referring medical specialty and detected pathology for small bowel double-contrast examinations. METHODS:Two hundred and forty-one (n = 143 females; n = 98 males; 01. 01.1990-31.12.1990) and 384 (n = 225 females; n = 159 males; 01.01.2004-31.12.2010) patients underwent enteroclysis, respectively. All examinations were performed in standardized double-contrast technique. After placement of a nasojejunal probe distal to the ligament of Treitz, radiopaque contrast media followed by X-ray negative distending contrast media were administered. Following this standardized projections in all four abdominal quadrants were acquired. Depending on the detected pathology further documentation was carried out by focused imaging. Examination protocols were reviewed and compared concerning requesting unit, indication and final report. RESULTS:Two hundred and forty-one examinations in 1990 faced an average of 55 examinations per year from 2004-2010. There was an increase of examinations for gastroenterological (33.6% to 64.6%) and pediatric (0.4% to 7.8%) indications while internal (29.0% to 6.0% for inpatients and from 16.6% to 9.1% for outpatients) and surgical (12.4% to 7.3%) referrals significantly decreased. "Follow-up of Crohn's disease" (33.1%) and "bleeding/tumor search" (15.1%) represented the most frequent clinical indications. A total of 34% (1990) and 53.4% (2004-2010) examinations yielded pathologic findings. In the period 01.01.2004 -31.12.2010 the largest proportion of pathological findings was found in patients with diagnosed Crohn's disease (73.5%), followed by patients with abdominal pain (67.6% with history of surgery and 52.6% without history of surgery), chronic diarrhea (41.7%), suspected Crohn's disease (39.5%) and search for gastrointestinal bleeding source/tumor (19.1%). The most common pathologies diagnosed by enteroclysis were "changes in Crohn's disease" (25.0%) and "adhesions /strictures" (12.2%).CONCLUSION: "Crohn's disease" represents the main indication for enteroclysis. The relative increase of pathologic findings reflects today's well directed use of enteroclysis.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Enteroclysis: Current clinical value

Maataoui

Vogl²,

Jacobi³

et al. 2013

WJR

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“…We are aware that there is no agreement in the literature about the usefulness of performing intestinal preparation before CT examination. Many authors [1,6,11] advise a light diet free of fruit and vegetables for 2 days before CT and the L M Minordi, A Vecchioli, P Mirk and L Bonomo administration of laxatives the day before. A few authors [12,13] advise fasting for 8-12 h prior to CT. We have been recommending our intestinal preparation for radiological study since 1980 and since 2000 for CT examination, and have found that the intestinal loops are usually clean so we plan to continue recommending this preparation.…”

Section: Discussionmentioning

confidence: 99%

CT enterography with polyethylene glycol solutionvsCT enteroclysis in small bowel disease

Minordi¹,

Vecchioli²,

Mirk³

et al. 2011

BJR

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Objective: The aim of the study is to compare CT enterography with polyethylene glycol solution (PEG-CT) with CT enteroclysis (CT-E) in patients with suspected small bowel disease. Methods: 145 patients underwent abdominal contrast-enhanced 16-row multidetector CT after administration of 2000 ml of PEG by mouth (n575) or after administration of 2000 ml of methylcellulose by nasojejunal tube (n570). Small bowel distension, luminal and extraluminal findings were evaluated and compared with small bowel followthrough examination in 60 patients, double contrast enema in 50, surgery in 25 and endoscopy in 35. Statistical evaluation was carried out by x 2 testing. For both techniques we have also calculated the effective dose and the equivalent dose in a standard patient. Results: Crohn's disease was diagnosed in 64 patients, neoplasms in 16, adhesions in 6. Distension of the jejunum was better with CT-E than PEG-CT (p,0.05: statistically significant difference). No significant difference was present for others sites (p.0.05). Evaluation of pathological ileal loops was good with both techniques. The values of sensitivity, specificity and diagnostic accuracy were respectively 94%, 100% and 96% with CT-E, and 93%, 94% and 93% with PEG-CT. The effective dose for PEG-CT was less than the dose for the CT-E (34.7 mSv vs 39.91 mSv). Conclusion: PEG-CT shows findings of Crohn's disease as well as CT-E does, although CT-E gives better bowel distension, especially in the jejunum, and has higher specificity than PEG-CT.

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“…Sin embargo, las desventajas intrínsecas del método: bajo valor predictivo negativo, operador dependiente, visualización indirecta de la pared y falta de visualización del compromiso extraintestinal entre otras, la han desplazado como técnica diagnóstica (8,9) . La enteroclisis por tomografía computada (E-TC) es hoy en día el método de imágenes de elección en el estudio de patología tumoral y no tumoral de ID (10)(11)(12) . Esta técnica combina las ventajas de la enteroclisis tradicional (adecuada distensión de asas intestinales) con las de la TC multicorte, con el potencial de demostrar en forma simultánea alteraciones intraluminales, murales y extraintestinales.…”

Section: Gastrointestinalunclassified

Utilidad De La Enteroclisis Por Tomografia Computada (E-Tc) en La Detección De Tumores De Intestino Delgado

2008

Rev. chil. radiol.

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Small bowel neoplasms are rare, accounting for approximately 3-6% of all primary malignancies of the gastrointestinal tract. MDCT-E is an imaging modality that combines the advantages of enteroclysis and helical CT, allowing the detection of small bowel diseases wherever they are located (intraluminal, intramural, or extramural). The aim of our study was to assess the reliability of MDCT-E IntroducciónLos tumores de intestino delgado (ID) son raros, representando aproximadamente 3-6% de las neoplasias del tubo digestivo; en pacientes sintomáticos hasta un 60% de los casos son malignos (1,2) . Generalmente tienen una presentación clínica inespecí-fica, similar a otros procesos que afectan al tracto gastrointestinal, por lo que su diagnóstico es tardío y difícil. En la mayoría de los casos son asintomáticos hasta etapas avanzadas de la enfermedad. Cuando presentan síntomas, los más comunes son: dolor abdominal, pérdida de peso, naúseas, vómitos, diarrea, hemorragia digestiva y obstrucción intestinal, que en general se relacionan con el tamaño tumoral y localización en el ID (3) . Los tumores benignos y malignos del ID pueden tener origen en todos los componentes histológicos que forman el intestino incluyendo: tejido epitelial, tejido linfoide, vasos, nervios y músculo (4) .Besa C. y cols. Utilidad de la enteroclisis por tomografía computada (E-TC) en la detección de tumores de intestino delgado. Rev Chil Radiol 2008; 14: 211-218.

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CT enteroclysis: technique and clinical applications

Cited by 53 publications

References 63 publications

Enteroclysis: Current clinical value

Enteroclysis: Current clinical value

CT enterography with polyethylene glycol solutionvsCT enteroclysis in small bowel disease

Utilidad De La Enteroclisis Por Tomografia Computada (E-Tc) en La Detección De Tumores De Intestino Delgado

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