Role of Multi-Slice CT Enterography as a Diagnostic Tool in Evaluating Small Bowel Disorders

Abstract

The most common small intestinal lesions include inflammation, neoplasms, malabsorption and vascular diseases. The diagnosis of small intestinal lesions is usually based on using different diagnostic procedures, including GIT enodoscopies; capsule enteroscopy and barium meal follow through, US, CT, MRI and angiography.

Increased speed and resolution of MSCT made it a first-line modality for the examination of small bowel disease. MSCTE differs from routine abdominopelvic CT in that it makes use of thin sections and large volumes of enteric contrast material to better display the small bowel lumen and wall. The use of neutral enteric contrast agents such as water combined with intravenously administered contrast material permit excellent assessment of hypervascular lesions due to inflammation or neoplasms.

This technique can also demonstrate the level and cause of obstruction as well as signs of threatened bowel viability and to exclude other causes of an acute abdomen. This makes it particularly valuable in the acute clinical setting.

Although conventional barium meal follow through and capsule endoscopy are the most common procedures used to visualize mucosal abnormalities, their use in evaluating the mural and extramural extents of small-bowel tumors is limited. In contrast to these modalities, MSCTE has the potential to simultaneously depict intraluminal, mural, and extraintestinal abnormalities.