Small-bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients.
OBJECTIVE
To prospectively evaluate multi-detector row helical computed tomographic (CT) enteroclysis for the depiction of small-bowel diseases.


METHODS
The study group included 107 patients who were suspected of having small-bowel tumor (n = 8), active inflammatory small-bowel disease (n = 18), unexplained gastrointestinal bleeding (n = 36), refractory celiac sprue (n = 14), and low-grade small-bowel obstruction (n = 31). A nasoenteric tube was positioned into the duodenojejunal junction by using fluoroscopic guidance and water was infused with a pressure-controlled pump. After intravenous administration of 120 mL of iodinated contrast material, multi-detector row helical CT enteroclysis images were obtained with 4 x 2.5 mm collimation (four detector rows and 2.5-mm section thickness). Multi-detector row helical CT enteroclysis findings were analyzed by two readers working in consensus. Findings were compared with the results of endoscopy, enteroscopy, videocapsule endoscopy, histopathologic analysis, or clinical follow-up.


RESULTS
Multi-detector row helical CT enteroclysis was well tolerated in 106 patients; one patient complained of abdominal pain after the examination. Multi-detector row helical CT enteroclysis allowed the diagnosis of small-bowel masses (n = 21), active Crohn disease (n = 9), small-bowel tuberculosis (n = 2), small-bowel lymphoma complicating celiac disease (n = 4), and confirmed low-grade small-bowel obstruction (n = 12). Multi-detector row helical CT enteroclysis demonstrated normal findings in 60 patients. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of multi-detector row helical CT enteroclysis were 100%, 95%, 97%, 94%, and 100%, respectively.


CONCLUSIONS
Multi-detector row helical CT enteroclysis allows depiction of small-bowel diseases in patients suspected of having small-bowel conditions.
Departments of Body and Vascular Imaging and Gastroenterology, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475 Paris cedex 10, France. mourad.boudiaf@lrb.ap-hop-paris.fr.
Mourad
M
Boudiaf
Ameer
A
Jaff
Philippe
P
Soyer
Yoram
Y
Bouhnik
Lounis
L
Hamzi
Roland
R
Rymer
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage; D003424:Crohn Disease / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging*; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*; D014385:Tuberculosis, Gastrointestinal / Q000000981:diagnostic imaging
D003287:Contrast Media