CT enterography

Computed tomographic (CT) enterography is a non-invasive technique for diagnosis of small bowel disorders.

  • evaluates the entire thickness of the bowel wall
  • offers information about the surrounding mesentery, the mesenteric vasculature and the perienteric fat
  • useful in the assessment of the solid organs and provides global overview of the abdomen 1
  • exposure to ionizing radiation

Adequate luminal distension is necessary as collapsed bowel loops may mimic pathology. CT enterography utilizes two types of contrast:

  • neutral oral contrast agents 1,3
    • these have attenuation similar to that of water e.g. water, PEG electrolyte solution, methyl cellulose
    • intravenous contrast is used with neutral agents
    • these agents allow better assessment of mucosal enhancement, mural thickness as well as mesenteric vasculature, this is important especially in the evaluation of Crohn's disease 2
  • positive contrast agents  3
    • such as a dilute (1%) barium solutions
    • they are not routinely used in CT enterography
    • pathologic mural enhancement and intestinal hemorrhage are obscured by positive contrast agents
    • mainly used to detect lower grades of small bowel obstruction and internal fistula
Procedure 

Actual procedure will vary depending on institutional protocol/guidelines but below is a typical description 1, 2:

  1. Abstain from all food and drink 4-6 hours before the exam.
  2. Patients drink about 1.5- 2 L of oral contrast over 40-60 minutes.
  3. Administration of intravenous contrast injection at a rate 4 mL/sec.
  4. CT scanning is ideally performed on a multi-detector computed tomography (MDCT) scanner about 45-65 seconds after contrast material injection in a single (venous) phase or dual (arterial and venous) phases for the evaluation of mesenteric vasculature or GI tract bleeding.
  5. Data interpretation with the use of axial and coronal reformatted images for proper evaluation.
CT examinations
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Article information

rID: 30358
Sections: Approach, Physics
Synonyms or Alternate Spellings:
  • Computed tomographic (CT) enterography

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Cases and figures

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    Case 1: normal CT enterography arterial phase
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    Case 1: portal venous phase
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    Case 2: Crohn disease
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    Case 3: Crohn disease
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    Case 4: Crohn disease with small bowel obstruction
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