Type:
Educational Exhibit
Keywords:
Gastrointestinal tract, CT-Enterography, Diagnostic procedure, Education and training
Authors:
E. LAZARIDOU, A. Hopkins, V. Mellou, S. Georgakopoulos, D. Stefanou, D. CHONDROS , D. Exarhos; ATHENS/GR
DOI:
10.26044/ecr2019/C-2201
Background
CT enterography (CTE) is a variation of routine CT that specifically assesses the extent and severity of small bowel disease.
(1) It is easily accessible as most hospitals are nowadays equipped with a CT scanner.
It is an examination that does not require sedation and is capable of producing high quality,
thin-section images very quickly.
CT imaging is essential in small bowel disease,
as it gives the radiologist the opportunity to assess its full length and different sites of the pathology,
evaluate the bowel wall thickness,
the extra-enteric structures,
including the solid organs of the abdomen and look for possible complications such as abscess and fistula.
(2)
Evaluation of the bowel wall is important as it may suggest a specific diagnosis and aid the clinician on how to proceed.
Bowel wall thickness is considered increased if it is measured thicker than 3mm in at least two planes.
Increased thickness segmentally may also represent a sessile mass.
Masses can also be pedunculated or polypoid.
Bowel lumen stenosis can be confirmed also by detecting it in more than one plane.
All of the above,
represent the first findings that prompt further investigation and attention to detail in order to suggest a more specific diagnosis.
(3)
One of the biggest advantages of CTE is the capability to visualize extraluminal structures,
such as the vessels,
lymph nodes and mesenteric fat.
Fibrofatty changes of the mesentery aid in localization of the abnormality.
Evaluation of the vessel patency and exclusion of mesenteric vessel thrombosis is essential when bowel ischemia is suspected.
The presence of lymph nodes suggests inflammation or raises suspicion of lymphoma.
All of the above depict how CTE can overcome its disadvantage of exposure radiation,
while respecting minimal possible dose exposure for the best diagnostic value.