Helical CT of the small bowel with an alternative oral contrast material in patients with Crohn disease.
BACKGROUND
We assessed the usefulness of helical computed tomography (CT) with a negative oral contrast material for detecting Crohn disease.


METHODS
Thirty-eight patients with proven Crohn disease were examined. We administered a large volume of a new negative oral contrast material (Mucofalk suspended in water) and then proceeded with helical CT scanning. This technique is an alternative to CT and conventional enteroclyses that use a nasojejunal tube. Two radiologists interpreted the scans, and patients were interviewed about their tolerance of the procedure. We created multiplanar reformatted images in all cases. Potential of small bowel distention by Mucofalk was evaluated by two observers on a three-point scale, and interobserver agreement was calculated with kappa statistics.


RESULTS
All patients who underwent enteroclysis stated that CT was the more comfortable method, the taste of the peroral contrast medium was considered good by 52.6% and acceptable by 47.4%. Small bowel distention was excellent in 55% of cases, moderate in 26%, and poor in 19%, with an interoberserver agreement of 78%. CT findings correlated with enteroclysis in 27 patients who underwent both methods. Analysis of CT versus enteroclysis showed a sensitivity of 89% for CT versus 78% for small bowel enteroclysis.


CONCLUSIONS
Mucofalk CT is a simple, rapid, noninvasive, and accurate method of evaluating extramucosal manifestations of Crohn disease. The tubeless procedure improved patients' comfort and decreased time, cost, and radiation exposure.
Department of Radiology, University Hospital of Graz, Auenbruggerplatz 9, A-8036 Graz, Austria.
O C
OC
Doerfler
A J
AJ
Ruppert-Kohlmayr
P
P
Reittner
T
T
Hinterleitner
W
W
Petritsch
D H
DH
Szolar
D000284:Administration, Oral; D000328:Adult; D003287:Contrast Media; D003424:Crohn Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging; D007472:Iohexol / Q000031:analogs & derivatives*; D008297:Male; D011620:Psyllium; D036542:Tomography, Spiral Computed
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide; D011620:Psyllium