Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease.
The purpose of this study was to evaluate the diagnostic accuracy of multidetector-CT enteroclysis (MDCT-E) versus barium enteroclysis with methylcellulose (BE) in clinically selected patients with suspected small bowel disease. We prospectively studied 52 patients who underwent unenhanced and contrast-enhanced multidetector CT (16 rows) after administration of 2-2.5 l of methylcellulose by naso-jejunal tube. BE was performed after administration of barium 60% w/v (200-250 ml) and methylcellulose (1-2 l). Patients with radiological signs of Crohn's disease were classified into the following subtypes: active, fibrostenotic, fistulising/perforating, reparative or regenerative subtypes. Twenty-eight patients also underwent endoscopy. The radiological prevalent subtype was the active subtype. The sensitivity, specificity and diagnostic accuracy of MDCT-E versus BE was 83%, 100% and 89%, respectively. BE showed five false negative CT cases due to early Crohn's disease; endoscopy confirmed positive cases of the CT and the BE, but showed one false negative case of the BE. Together, MDCT enteroclysis and BE permitted the diagnosis of Crohn's disease in 30 patients, adhesions in one patient, lymphoma in two patients and carcinoid tumours in two patients. In conclusion, MDCT-E permits good representation of pathological patterns. Early stages of Crohn's disease are better evaluated by BE.
Dipartimento di Bioimmagini e Scienze Radiologiche, Istituto di Radiologia, UCSC, l.go A.Gemelli, Rome, Italy. lmminordi@rm.unicatt.it
Laura Maria
LM
Minordi
Amorino
A
Vecchioli
Luisa
L
Guidi
Paoletta
P
Mirk
Luisa
L
Fiorentini
Lorenzo
L
Bonomo
D000328:Adult; D000368:Aged; D001466:Barium Sulfate / Q000008:administration & dosage; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D007441:Intubation, Gastrointestinal; D008297:Male; D008747:Methylcellulose / Q000008:administration & dosage; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*
D003287:Contrast Media; D001466:Barium Sulfate; D008747:Methylcellulose