Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease.

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Title: Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease.
Authors: Minordi, Laura Maria1 lmminordi@rm.unicatt.it, Vecchioli, Amorino1, Guidi, Luisa2, Mirk, Paoletta1, Fiorentini, Luisa1, Bonomo, Lorenzo1
Source: European Radiology. Jul2006, Vol. 16 Issue 7, p1527-1536. 10p. 11 Black and White Photographs, 5 Charts.
Subjects: Small intestine radiography, Intestinal diseases, Endoscopy, Crohn's disease, Patients, Crohn's disease diagnosis, Barium sulfate, Cellulose, Comparative studies, Computed tomography, Diagnostic imaging, Small intestine, Research methodology, Medical cooperation, Research, Research evaluation, Gastric intubation, Evaluation research, Randomized controlled trials, Contrast media, Equipment & supplies
Abstract: The purpose of this study was to evaluate the diagnostic accuracy of multidetector-CT enteroclysis (MDCT-E) versus barium enteroclysis with methylcellulose (BE) in clinically selected patients with suspected small bowel disease. We prospectively studied 52 patients who underwent unenhanced and contrast-enhanced multidetector CT (16 rows) after administration of 2-2.5 l of methylcellulose by naso-jejunal tube. BE was performed after administration of barium 60% w/v (200-250 ml) and methylcellulose (1-2 l). Patients with radiological signs of Crohn's disease were classified into the following subtypes: active, fibrostenotic, fistulising/perforating, reparative or regenerative subtypes. Twenty-eight patients also underwent endoscopy. The radiological prevalent subtype was the active subtype. The sensitivity, specificity and diagnostic accuracy of MDCT-E versus BE was 83%, 100% and 89%, respectively. BE showed five false negative CT cases due to early Crohn's disease; endoscopy confirmed positive cases of the CT and the BE, but showed one false negative case of the BE. Together, MDCT enteroclysis and BE permitted the diagnosis of Crohn's disease in 30 patients, adhesions in one patient, lymphoma in two patients and carcinoid tumours in two patients. In conclusion, MDCT-E permits good representation of pathological patterns. Early stages of Crohn's disease are better evaluated by BE. [ABSTRACT FROM AUTHOR]
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Abstract:The purpose of this study was to evaluate the diagnostic accuracy of multidetector-CT enteroclysis (MDCT-E) versus barium enteroclysis with methylcellulose (BE) in clinically selected patients with suspected small bowel disease. We prospectively studied 52 patients who underwent unenhanced and contrast-enhanced multidetector CT (16 rows) after administration of 2-2.5 l of methylcellulose by naso-jejunal tube. BE was performed after administration of barium 60% w/v (200-250 ml) and methylcellulose (1-2 l). Patients with radiological signs of Crohn's disease were classified into the following subtypes: active, fibrostenotic, fistulising/perforating, reparative or regenerative subtypes. Twenty-eight patients also underwent endoscopy. The radiological prevalent subtype was the active subtype. The sensitivity, specificity and diagnostic accuracy of MDCT-E versus BE was 83%, 100% and 89%, respectively. BE showed five false negative CT cases due to early Crohn's disease; endoscopy confirmed positive cases of the CT and the BE, but showed one false negative case of the BE. Together, MDCT enteroclysis and BE permitted the diagnosis of Crohn's disease in 30 patients, adhesions in one patient, lymphoma in two patients and carcinoid tumours in two patients. In conclusion, MDCT-E permits good representation of pathological patterns. Early stages of Crohn's disease are better evaluated by BE. [ABSTRACT FROM AUTHOR]
ISSN:09387994
DOI:10.1007/s00330-006-0185-6