Possible Small-Bowel Neoplasms: Contrast-enhanced and Water-enhanced Multidetector CT Enteroclysis

Pilleul, F.; Penigaud, Marianne; Milot, Laurent; Saurin, Jean‐Christophe; Chayvialle, Jean‐Alain; Valette, Pierre-Jean

doi:10.1148/radiol.2413051429

Cited by 158 publications

(86 citation statements)

References 15 publications

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“…The high spatial resolution of CT enterography, together with its relative insensitivity to motion and breathing artefacts, arguably make it more suitable for the detection of small bowel tumours than MR enterography. Pilleul et al [45], for example, reported a sensitivity of 84.7% and a specificity of 96.9% for detection of small bowel tumours using CT enterography. Table 8 lists the commoner small bowel tumours, and provides information on incidence and imaging characteristics.…”

Section: Small Bowel Tumoursmentioning

confidence: 99%

CT enterography: review of technique and practical tips

Ilangovan¹,

Burling²,

George³

et al. 2012

BJR

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ABSTRACT. CT enterography is a new non-invasive imaging technique that offers superior small bowel visualisation compared with standard abdomino-pelvic CT, and provides complementary diagnostic information to capsule endoscopy and MRI enterography. CT enterography is well tolerated by patients and enables accurate, efficient assessment of pathology arising from the small bowel wall or surrounding organs. This article reviews the clinical role of CT enterography, and offers practical tips for optimising technique and accurate interpretation. Until recently, diagnosis of small bowel pathology had relied primarily on radiological techniques, in part due to the relative inaccessibility of the small bowel to conventional endoscopy. However, new endoscopic developments-notably the recent introduction of capsule endoscopy and double balloon enteroscopy-are challenging this position. Capsule endoscopy, for example, is now generally accepted as first-line investigation for occult gastrointestinal haemorrhage, and increasingly advocated for diagnosis of early Crohn's disease. However, the radiological community has not stood still. In parallel with the development of new endoscopic techniques, rapid progress has been made in crosssectional imaging technologies, harnessing the power of multidetector row CT (MDCT), MRI and ultrasound, facilitating rapid, accurate and minimally invasive investigation of the small bowel and adjacent tissues.CT enterography was first introduced by Raptopoulos et al [1] in 1997 as a modification to ''standard'' abdomino-pelvic CT examination to specifically examine the small bowel in detail, notably to assess the extent and severity of Crohn's disease [1,2]. They combined neutral (low-density) oral contrast with ''enteric phase'' CT to optimise contrast resolution between mucosa and lumen, thereby maximising conspicuity of abnormalities arising from the small bowel wall. Several authors have subsequently described similar techniques, which are broadly categorised into CT enterography (where patients drink oral contrast) and CT enteroclysis (luminal contrast is introduced via a nasojejunal tube placed fluoroscopically prior to CT examination). Although superior jejunal distension is attained using enteroclysis, the convenience, efficiency and superior patient experience achieved with CT enterography make it the preferred technique at the authors' institutions, and therefore the focus of this review. This paper will critically review the CT enterography technique and provide practical tips on interpretation to assist radiologists and help them avoid common interpretative pitfalls. We will also examine its role relative to other complementary non-ionising radiation radiological tests. TechniqueThe technique of CT enterography combines small bowel distension with a neutral or low-density oral contrast mixture and abdomino-pelvic CT examination during the enteric phase following administration of intravenous contrast. Patients drink approximately 1.5-2 l of oral contrast over 45-60 min. Patient comp...

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Section: Small Bowel Tumoursmentioning

confidence: 99%

CT enterography: review of technique and practical tips

Ilangovan¹,

Burling²,

George³

et al. 2012

BJR

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“…Májmetasztázisok esetében érzékenysége 83%, fajlagossága 76% [21]. Vékonybél-NET-ek kimutatásában a CT-enteroclysis jelenthet segítséget; érzé-kenysége 85%, fajlagossága 97% [22].…”

Section: Ct Mriunclassified

Diagnosis and treatment options of neuroendocrine tumours

Uhlyarik¹,

Pápai²

2013

Orvosi Hetilap

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A neuroendokrin daganatok ritkák; klinikai jelentőségüket alacsony incidenciájuk ellenére magas prevalenciájuk mutatja. A korai felismerés és a megfelelően megválasztott terápia jelentőségére utal, hogy metasztatikus esetekben a betegek túlélési mutatói egyéb előrehaladt daganatos betegségek túlélési adataival megegyeznek. Osztályozásuk jelenleg patológiai jellemzők, a WHO 2010-es javaslata alapján történik. Megkülönböztetünk nem funkcionáló, valamint klinikai szindrómákat okozó, funkcionálisan aktív daganatokat. A nem funkcionáló daganatok növekedésük-ből származó helyi tüneteket okoznak. A funkcionáló daganatok esetében ezekhez jól meghatározott endokrin szindrómák is társulhatnak. A laboratóriumi vizsgálatok közül alapvető jelentőségű a szérum-kromogranin-A mint biomarker meghatározása. A daganatok lokalizációjában a hagyományos képalkotó és endoszkópos vizsgálatok mellett a funkcionális leképezésnek, izotópvizsgálatoknak van fontos szerepe. A terápia során elsődleges a primer tumor eltávolítása. Előrehaladt betegség kezelésekor metastasectomia, intervenciós radiológiai módszerek, gyógy-szeres kezelés és endoradioterápia egyaránt alkalmazható. Jelen összefoglaló célja a neuroendokrin tumorok tünetei-nek, diagnosztikus lehetőségeinek áttekintése, valamint a rendelkezésre álló terápiás lehetőségek bemutatása. Orv. Hetil., 2013, 154, 1549-1555 Kulcsszavak: neuroendokrin daganat, endokrin szindróma, kromogranin-A, képalkotó vizsgálat, terápia Diagnosis and treatment options of neuroendocrine tumoursNeuroendocrine neoplasms belong to the group of rare tumours. Their clinical importance may be highlighted by their high prevalence despite low incidence. Since survival rate is similar to other progressive neoplastic diseases in metastatic cases, early recognition and appropriate therapy of these neoplasms are equally important. Classifi cation of neuroendocrine tumours is based on their pathologic characteristics according to the 2010 WHO recommendation. Non-functioning tumours cause local symptoms due to their mass effect, while functioning tumours produce welldefi ned endocrine syndromes. Among laboratory tests, serum chromogranin-A is considered the most important biomarker of both non-functioning and functioning neuroendocrine tumours. Localization of these tumours includes the use of conventional diagnostic imaging, endoscopic examinations, and functional imaging studies. With respect to treatment, elimination of the primary tumour remains one of the most important issues. In advanced cases of the disease metastasectomy, interventional radiologic methods, medical treatment and endoradiotherapy can be used. The aim of this review is to summarize briefl y the symptoms, diagnostic methods and treatment options of neuroendocrine tumours. Orv. Hetil., 2013, 154, 1549-1555 Keywords: neuroendocrine tumour, endocrine syndrome, chromogranin A, diagnostic imaging, therapy (Beérkezett: 2013. augusztus 15.; elfogadva: 2013. szeptember 5.) A szerkesztőség felkérésére készült közlemény. Rövidítések AC = atípusos carcinoid;...

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“…CT enteroclysis can also be used to increase the sensitivity for detecting small bowel lesions [26].…”

Section: Symptomatology and Diagnosismentioning

confidence: 99%

Small Bowel Adenocarcinoma – Report of Two Cases and Review of Literature

2012

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Although accounting for 90 % of the intestinal surface area, small bowel adenocarcinomas are not common. The majority of these lesions are incidentally detected during laparotomy for intestinal obstruction or perforation. The symptoms associated with these lesions are not very specific and preoperative diagnosis is rare. We report two cases of jejunal adenocarcinomas detected in patients undergoing laparotomy for acute abdomen and review the literature for small bowel adenocarcinomas.

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Possible Small-Bowel Neoplasms: Contrast-enhanced and Water-enhanced Multidetector CT Enteroclysis

Abstract: Contrast- and water-enhanced multidetector CT enteroclysis had an overall accuracy of 84.7% for depiction of small-bowel neoplasms.

Cited by 158 publications

References 15 publications

CT enterography: review of technique and practical tips

CT enterography: review of technique and practical tips

Diagnosis and treatment options of neuroendocrine tumours

Small Bowel Adenocarcinoma – Report of Two Cases and Review of Literature

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