Computed Tomography Enterography

Computed Tomography Enterography: How It Differs From Routine Abdominal Computed Tomography

Computed tomography enterography (CTE) reflects individualization of the abdominal pelvic CT technique for patients with small bowel disorders. CTE provides visualization of the small bowel lumen, wall, and perienteric tissues by distending the small bowel with large volumes of oral contrast and obtaining multiplanar, high-resolution images of the bowel during appropriate phase(s) of enhancement. It differs from routine abdominal pelvic CT in the amount and type of oral contrast given to the patient prior to scanning, timing of image acquisition with respect to the intravenous (IV) contrast bolus, routine reconstruction of thin multiplanar images, and other factors related to patient-specific indications (e.g., Crohn’s disease or obscure gastrointestinal [GI] bleeding). CT acquisition for CT enteroclysis is similar, but the luminal small bowel distention is achieved by infusion of enteric contrast via a nasojejunal tube.

Indications

CTE is performed in patients with known or suspected Crohn’s disease, patients with obscure GI bleeding, diarrhea of unknown cause (often in association with imaging of the pancreas), and in patients with abdominal pain of unknown cause in an outpatient setting. Multiphase CTE is often used as a complementary technique with capsule endoscopy in patients with obscure GI bleeding, and its complementarity with other tests is reviewed later in this chapter. CTE may also be used to evaluate for the presence and cause of low-grade obstruction (when an enteroclysis cannot be performed) and to examine for findings or complications of other small bowel disorders (e.g., small bowel diverticulosis, celiac disease, poly-posis syndromes).

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