Crohn disease of the small bowel: spiral CT evaluation after oral hyperhydration with isotonic solution.
OBJECTIVE
Our aim was to evaluate the accuracy of spiral CT study of small-bowel Crohn disease with use of oral hyperhydration with isoosmotic solution.


METHODS
We prospectively analyzed 33 consecutive patients and 10 control subjects with spiral CT after oral administration of 2,000 ml of polyethylene glycol electrolyte-balanced solution. The CT diagnoses were compared with the results of conventional radiologic oral barium examination (33 cases), ileum colonoscopy (8 cases), and surgery (4 cases).


RESULTS
The final diagnoses were Crohn disease (14 cases), no small-bowel disease (16 cases), cancer of ileocecal valve (1 case), carcinosis of mesenteric root (1 case), and intestinal lymphangiectasia (1 case). In the control group, no abnormalities of the small bowel were found. The sensitivity of spiral CT was 85.7%, specificity 100%, positive predictive value 100%, negative predictive value 90%, and diagnostic accuracy 93.9%.


CONCLUSIONS
Our method allowed adequate distension of the small bowel for spiral CT studies, thus resulting in a safe and effective alternative to small-bowel spiral CT enema, which can be used in patients that refuse the nasojejunal balloon catheter.
Mazzeo
S
S
Department of Radiology, University Hospital of Pisa, Pisa, Italy. smazzeo@do.med.unipi.it
Caramella
D
D
Battolla
L
L
Melai
L
L
Masolino
P
P
Bertoni
M
M
Giusti
P
P
Cappelli
C
C
Bartolozzi
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D003424:Crohn Disease / Q000000981:diagnostic imaging*; D005079:Excipients / Q000008:administration & dosage; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology; D007552:Isotonic Solutions / Q000008:administration & dosage; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D005079:Excipients; D007552:Isotonic Solutions; D011092:Polyethylene Glycols