Aims and objectives
The role of CT Enterography (CTE) in patients with Crohn’s Disease (CD) has been well established: it is an accurate tool for the evaluation of disease extension and for detection of complications,
even in a subclinical stage,
thus changing the management of disease [1; 2].
The main concern about the utilization of CTE in this scenario is due to the relatively high radiation exposure in young population undergoing to repeated examinations [3].
The application of material decomposition algorithms for selective subtraction of iodine from Dual...
Methods and materials
Patient Selection
Patients >18 y.o.
with known endoscopic or pathological diagnosis of CD who underwent to CTE between February and November 2018 with a 3rd generation dual Source DECT (dsDECT) were included.
Patients with contraindication to iodinated contrast material or with lack of clinical or pathological documentation were excluded.
CTE Scan Protocol
A water solution of polyethylene glycol was administered to all patients before CTE (Macrogol,
Macro P,
Alfasigma,
Milan,
Italy).
All patients also received a spasmolytic agent (Hyoscine Butylbromide,
20 mg iv,
Buscopan,
Boehringer...
Results
A total of 28 patients (16 M; 12 F) with a median age of 44 years (interquartile range: 32 – 61 years) were scanned with a 3rd generation dsDECT.
Qualitative analysis of 120kVp TNC and VNC images recorded a median score of 4 (range 2 – 5) for both,
with significant differences (Wilcoxon p = 0.032).
Quantitative analysis demonstrated significantly higher SNR for 120 kVp TNC in jejunum and jejuno-ileal tract (Figure 2),
while CNR was for 120 kVp TNC in involved segments by CD...
Conclusion
Qualitative and quantitative analysis of VNC images obtained from enterographic phase of CTE provided variable results,
with significant differences in imqge quality and attenuation values of different districts.
References
Gomollon F,
Dignass A,
Annese V et al (2017) 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management.
J Crohns Colitis 11:3-25
Bruining DH,
Siddiki HA,
Fletcher JG et al (2012) Benefit of computed tomography enterography in Crohn's disease: effects on patient management and physician level of confidence.
Inflamm Bowel Dis 18:219-225
Chatu S,
Subramanian V,
Pollok RC (2012) Meta-analysis: diagnostic medical radiation exposure in inflammatory bowel disease.
Aliment Pharmacol Ther 35:529-539
McCollough CH,
Leng...