title: Quality, clinical influence and tolerance of computed tomography enteroclysis in patients with suspected small bowel disease.
abstract: BACKGROUND
  Computed tomography enteroclysis (CTE) may be superior to other small bowel imaging techniques, detecting subtle mucosal lesions and extraluminal pathology. This study aimed to define the technical success, clinical influence and tolerance of CTE in patients with suspected small bowel disease.
  
  
  METHODS
  CTE scans of 42 consecutive patients (aged 21-78 years, 12 men) were reviewed by a single radiologist for technical adequacy and diagnosis. A panel of gastroenterologists reviewed clinical information. At a telephone interview, tolerance of CTE was graded numerically from 1 (unbearable) to 10 (excellent) and descriptively as unbearable, fair, good or excellent.
  
  
  RESULTS
  Good or optimal distension of small bowel was achieved in 98%. The entire small bowel was imaged in 88%. Eighteen patients had a normal small bowel, whereas 12 (29%) had active small bowel Crohn disease, 4 intussusception, 3 small bowel diverticula and 7 having other diagnoses. Mesenteric lymphadenopathy was evident in 11 and fat stranding in 5. CTE resulted in a new or altered diagnosis in 13 (31%) patients and identified more extensive Crohn disease in a further 8 (19%). A change in management plan was instituted in 18 (43%) patients, with subsequent clinically significant improvement in 12. 33 (85%) described the procedure as 'fair' or 'unbearable' rather than 'good' or 'excellent'. The median tolerance score was 3 out of 10.
  
  
  CONCLUSIONS
  CTE provided high-quality images in nearly all patients and had an effect on diagnosis, management or outcome in most, but was not well tolerated.
authors.affiliation: Department of Gastroenterology and Hepatology, Box Hill Hospital, Melbourne, Victoria, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Moss
authors.forename: F J
authors.initials: FJ
authors.lastname: Parrish
authors.forename: P M
authors.initials: PM
authors.lastname: Irving
authors.forename: M L
authors.initials: ML
authors.lastname: Haines
authors.forename: P R
authors.initials: PR
authors.lastname: Gibson
mesh_terms: D000328:Adult; D000368:Aged; D005215:Fasting; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000592:standards; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000592:standards*; D055815:Young Adult