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1 From the Department of Diagnostic Radiology (P.B.W., J.G.F., C.D.J.) and Division of Gastroenterology, Department of Internal Medicine (W.J.S.), Mayo Clinic, 200 First St SW, Rochester, MN 55905. From the 2001 RSNA scientific assembly. Received July 19, 2002; revision requested August 29; revision received December 24; accepted January 15, 2003. Address correspondence to J.G.F. (e-mail: fletcher.joel@mayo.edu).
A feasibility study was conducted to evaluate two biphasic computed tomographic (CT) enterography protocols, a noninvasive CT technique with water administered perorally and CT enteroclysis with methylcellulose administered through a nasojejunal tube, in 23 patients known or suspected to have Crohn disease. Results were compared with the results of fluoroscopic small bowel examination and terminal ileoscopy for the detection of active Crohn disease in the terminal ileum. Luminal distention did not differ significantly between the two CT protocols. Arterial phase imaging was noncontributory in 22 of 23 cases. The noninvasive peroral water CT enterography protocol had similar accuracy (12 of 15 cases, 80%) for enabling the detection of active Crohn disease in comparison with CT enteroclysis with nasojejunal tube (seven of eight, 88%) and fluoroscopic small bowel examination (17 of 23, 74%). No fistulas were missed with use of either CT technique. The authors conclude that noninvasive peroral portal venous phase CT enterography with use of water is an accurate and feasible technique for detecting active small bowel inflammation in patients with Crohn disease.
© RSNA, 2003
Index terms: Contrast media, comparative studies • Crohn disease, 74.262 • Enteritis, 742.26 • Ileum, 742.262 • Intestines, CT, 742.1211
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