CT enterography

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

CT enterography, similarly to MRI enterography, is most commonly used to evaluate patients with Crohn disease where it is used for assessment of the primary disease and any complications. Other indications include celiac disease, postoperative adhesionsradiation enteritisscleroderma, small bowel malignancies, and polyposis syndromes.

  • useful in the assessment of the solid organs and provides a global overview of the abdomen 1

Note: This article is intended to outline some general principles of protocol design. The specifics will vary depending on CT hardware and software, radiologist's and referrer's preference, institutional protocols, and patient factors (e.g. allergy and fluid intake restrictions). 

  1. abstain from all food and drink 4-6 hours before the exam
  2. patients drink about 1.5 L of oral contrast over 30-60 minute
    • adequate luminal distension is necessary as collapsed bowel loops may mimic pathology
    • CT enterography utilizes negative or neutral oral contrast 1-3
      • attenuation similar to that of water - e.g. water, PEG, mannitol, methylcellulose, locust bean gum, and low-density barium sulphate preparations (Volumen, 0.1% W/V) 

Fluid distension of the small bowel allows better assessment of mucosal enhancement, mural thickness as well as mesenteric vasculature, this is important especially in the evaluation of Crohn disease 2.​

  • CT scanning is ideally performed on a multi-detector computed tomography (MDCT) scanner
  • intravenous contrast
    • Crohn disease, celiac disease, postoperative adhesions, radiation enteritis, and scleroderma: a single enteric phase where peak mucosal enhancement is achieved is sufficient - either enteric phase (45-50s) or portal venous phase (60-70s)
    • small bowel tumors: an additional arterial phase can be performed, in particular for the assessment of hypervascular lesions (e.g. neuroendocrine tumors) 
    • in cases of suspected GI bleeding, pre-contrast, arterial, portal venous, and delayed phases should be considered
  • ​data interpretation with the use of axial and coronal reformatted images for proper evaluation
CT examinations

Article information

rID: 30358
Section: Approach
Synonyms or Alternate Spellings:
  • Computed tomographic (CT) enterography

ADVERTISEMENT: Supporters see fewers/no ads

Cases and figures

  • Case 1: normal CT enterography arterial phase
    Drag here to reorder.
  • Case 1: portal venous phase
    Drag here to reorder.
  • Case 2: Crohn disease
    Drag here to reorder.
  • Case 3: Crohn disease
    Drag here to reorder.
  • Case 4: Crohn disease with small bowel obstruction
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.