Role of Computed Tomography (CT) Enterography in the Evaluation of Small Bowel Diseases

Abstract

BACKGROUND Small bowel imaging often questions clinicians due to its long, tortuous and undulating morphology. The current study was undertaken to establish the efficacy of multidetector computed tomography (MDCT) enterography in the evaluation of small bowel diseases using iso-osmotic mannitol as oral contrast agent. METHODS A prospective observational study was conducted among thirty patients (mean age 40 years; range 14 - 66 years), 16 males and 14 females presenting with clinical suspicion of small bowel diseases based on clinical, laboratory or other imaging investigations underwent CT enterography on a 128 slice CT scanner using isoosmotic mannitol as neutral enteral contrast. RESULTS Intestinal tuberculosis was the most common diagnosis. Non neoplastic cases predominantly showed segmental symmetrical involvement with target pattern of enhancement. Small bowel tumours (adenocarcinoma) were seen in 2 cases. Neoplasms were associated with focal asymmetrical involvement with heterogeneous enhancement pattern. Computerized tomography enterography (CTE) clearly depicted the site, level and cause of the obstruction in all the patients with a sensitivity and specificity of 96 % and 100 % respectively. Diagnostic accuracy of CTE in detection of small bowel diseases came out to be 98 %. CONCLUSIONS CT enterography is an effectual, non-invasive, well-tolerated, sensitive and specific imaging modality for the evaluation of small bowel diseases which provides superior assessment of the intraluminal, mural and extraintestinal pathologies. KEY WORDS CT enterography, mannitol, Tuberculosis, Small Bowel