CT enterography with polyethylene glycol solution vs CT enteroclysis in small bowel disease.
OBJECTIVE
The aim of the study is to compare CT enterography with polyethylene glycol solution (PEG-CT) with CT enteroclysis (CT-E) in patients with suspected small bowel disease.


METHODS
145 patients underwent abdominal contrast-enhanced 16-row multidetector CT after administration of 2000 ml of PEG by mouth (n = 75) or after administration of 2000 ml of methylcellulose by nasojejunal tube (n = 70). Small bowel distension, luminal and extraluminal findings were evaluated and compared with small bowel follow-through examination in 60 patients, double contrast enema in 50, surgery in 25 and endoscopy in 35. Statistical evaluation was carried out by χ² testing. For both techniques we have also calculated the effective dose and the equivalent dose in a standard patient.


RESULTS
Crohn's disease was diagnosed in 64 patients, neoplasms in 16, adhesions in 6. Distension of the jejunum was better with CT-E than PEG-CT (p<0.05: statistically significant difference). No significant difference was present for others sites (p>0.05). Evaluation of pathological ileal loops was good with both techniques. The values of sensitivity, specificity and diagnostic accuracy were respectively 94%, 100% and 96% with CT-E, and 93%, 94% and 93% with PEG-CT. The effective dose for PEG-CT was less than the dose for the CT-E (34.7 mSv vs 39.91 mSv).


CONCLUSIONS
PEG-CT shows findings of Crohn's disease as well as CT-E does, although CT-E gives better bowel distension, especially in the jejunum, and has higher specificity than PEG-CT.
Department of Bio-Imaging and Radiological Sciences, Radiology Institute, UCSC, Rome, Italy. lauraminordi@virgilio.it
L M
LM
Minordi
A
A
Vecchioli
P
P
Mirk
L
L
Bonomo
D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
D003287:Contrast Media; D005765:Gastrointestinal Agents; D011092:Polyethylene Glycols