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Multi–Detector Row CT of the Small Bowel: Peak Enhancement Temporal Window—Initial Experience¹

¹ From the Department of Radiology, Duke University Medical Center, Box 3808, Erwin Rd, Durham, NC 27710. Received March 25, 2006; revision requested May 24; revision received June 25; accepted July 21; final version accepted September 27. Supported by a grant from E-Z-Em, Westbury, NY. Address correspondence to R.C.N. (e-mail: rendon.nelson{at}duke.edu).

Purpose: To prospectively determine quantitatively and qualitatively the timing of maximal enhancement of the normal small-bowel wall by using contrast material–enhanced multi–detector row computed tomography (CT).

Materials and Methods: This HIPAA-compliant study was approved by the institutional review board. After information on radiation risk was given, written informed consent was obtained from 25 participants with no history of small-bowel disease (mean age, 58 years; 19 men) who had undergone single-level dynamic CT. Thirty seconds after the intravenous administration of contrast material, a serial dynamic acquisition, consisting of 10 images obtained 5 seconds apart, was performed. Enhancement measurements were obtained over time from the small-bowel wall and the aorta. Three independent readers qualitatively assessed small-bowel conspicuity. Quantitative and qualitative data were analyzed during the arterial phase, the enteric phase (which represented peak small-bowel mural enhancement), and the venous phase. Statistical analysis included paired Student t test and Wilcoxon signed rank test with Bonferroni correction. A P value less than .05 was used to indicate a significant difference.

Results: The mean time to peak enhancement of the small-bowel wall was 49.3 seconds ± 7.7 (standard deviation) and 13.5 seconds ± 7.6 after peak aortic enhancement. Enhancement values were highest during the enteric phase (P < .05). Regarding small-bowel conspicuity, images obtained during the enteric phase were most preferred qualitatively; there was a significant difference between the enteric and arterial phases (P < .001) but not between the enteric and venous phases (P = .18).

Conclusion: At multi–detector row CT, peak mural enhancement of the normal small bowel occurs on average about 50 seconds after intravenous administration of contrast material or 14 seconds after peak aortic enhancement.

© RSNA, 2007

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