Learning objectives
To describe the technique of helical contrast enhanced CT enterography.To illustrate and review the spectrum of findings of small-bowel Crohn disease at abdomino-pelvic spiral CT after oral hyperhidration with an isotonic solution.To understand the role of CT in the assessment of the extent, severity and activity of Crohn disease as well as its limitations.
Background
Crohn disease is a chronic granulomatous disorder of the alimentary tract that causes transmural inflammation of the bowel wall, often extending to the serosa and mesenteric lymph nodes. Although the terminal ileum and proximal colon are the most frequently affected, it can involve any portion of the alimentary tract. Barium examinations, including small bowel follow-through, enteroclysis, and CT have been the main radiologic modalities used in the evaluation of Crohn disease. Barium studies provide superb visualization of the bowel mucosa but are unable to show...
Imaging findings OR Procedure details
CROHN DISEASE: SPECTRUM OF FINDINGS ON HELICAL CONTRAST-ENHANCED CT ENTEROGRAPHYTECHNIQUE OF CONTRAST-ENHANCED CT ENTEROGRAPHY AND NORMAL FINDINGSComplete opacification of a well-distended gut is mandatory for accurate CT evaluation of the bowel wall thickening characteristic of Crohn disease. The technique of CT enteroclysis has been previously described (1, 3). Due to the invasive nature of the intubation procedure we have been using a similar technique that relies on oral hyperhidration (contrast-enhanced CT enterography) and is very well accepted by patients (4).The small bowel is distended by...
Conclusion
Contrast-enhanced CT enterography provides important information about the extent and activity of small-bowel Crohn disease and its extraluminal involvement, being a potential alternative to CT enteroclysis.
References
1. Kloppel R, Thiele J, Bosse J. The Sellink CT method [in German]. Roto Fortschr Geb Roentgenstr Neven Bildeg Vertahr 1992; 156:291-2922. Prassopoulos P, Papanikolaou N, Grammatikakis J, Rousomoustakaki M, Maris T, Gourtsoyiannis N. MR enteroclysis imaging of Crohns disease. Radiographics 2001; 21:S161-S1723. Rollandi GA, Curone PF, Biscaldi E, et al. Spiral CT of the abdomen after distension of small bowel loops with transparent enema in patients with Crohns disease. Abdom Imaging 1999; 24:544-5494. Mazzeo S, Caramella D, Battola L, et al. Crohn disease of...
