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Computed tomography enterography

Yao He, Zhenhua Zhu, Yujun Chen, Fang Chen, Yufang Wang, Chunhui Ouyang, Hong Yang, Meifang Huang, Xiaodong Zhuang, Ren Mao, Shomron Ben-Horin, Xiaoping Wu, Qin Ouyang, Jiaming Qian, Nonghua Lu, Pinjing Hu, Minhu Chen
OBJECTIVES: Differentiating Crohn's disease (CD) from intestinal tuberculosis (ITB) remains a diagnostic challenge. Misdiagnosis carries potential grave implications. We aimed to develop and validate a novel diagnostic nomogram for differentiating them. METHODS: In total, 310 eligible patients were recruited from 6 tertiary inflammatory bowel disease centers. Among them, 212 consecutive patients (143 CD and 69 ITB) were used in the derivation cohort for the establishment of diagnostic equation and nomogram; 7 investigative modalities including clinical manifestations, laboratory results, endoscopic findings, computed tomography enterography features, and histology results were used to derive the diagnostic model and nomogram...
March 2019: American Journal of Gastroenterology
Paolo Fraticelli, Massimo Mattioli, Devis Benfaremo, Lorenzo Biondi, Marco Cardinali, Armando Gabrielli
A 26-year-old man was referred to our department for a 3-year history of dyspepsia responsive to oral pump-inhibitors therapy. During the last year, he underwent a gastroscopy, a colonoscopy and a computed tomography enterography that failed to reveal an underlying organic disease: a diagnosis of functional dyspepsia was made. Because of the persistence of symptoms, he came to our ambulatory where we performed an abdominal ultrasound that revealed the presence of multiple bi-lobar lesions of the liver suspected for metastases and a hypoechoic solid lesion of the pancreas body, confirmed by a contrast enhanced computed tomography...
January 15, 2019: Acta Bio-medica: Atenei Parmensis
Jieun Kim, Seung Ho Kim, Tae Oh Kim
BACKGROUND: Unnecessary prolonged treatment with biologic agents for Crohn's disease (CD) patients with endoscopic complete remission (CR) might increase the opportunistic infections. PURPOSE: To evaluate computed tomography enterography (CTE) findings obtained on CD patients achieving endoscopic CR after anti-tumor necrosis factor (TNF)-α therapy. MATERIAL AND METHODS: Thirty-six consecutive patients with CD who had received anti-TNF- α therapy and undergone pre-and post-therapy CTE and ileocolonoscopy were initially enrolled...
January 10, 2019: Acta Radiologica
Ying Chen, Yonghua Tang, Chunhong Hu, Shuangqing Chen
OBJECTIVE: The aim of this study was to evaluate the computed tomography enterography (CTE) characteristics of bleeding Meckel diverticulum. METHODS: The CTE images of 35 patients with Meckel diverticulum and gastrointestinal bleeding were retrospectively evaluated. RESULTS: Meckel diverticulum was visualized in 33 of 35 patients and located in the right lower abdomen (20/33), midline lower abdomen (8/33), left lower abdomen (3/33), or paramedially near the umbilicus (2/33)...
December 10, 2018: Journal of Computer Assisted Tomography
Jingyun Cheng, Hui Xie, Hao Yang, Ke Wang, Guobin Xu, Guangyao Wu
[This corrects the article DOI: 10.1155/2018/7351936.].
2018: Gastroenterology Research and Practice
Lin Wang, Shenchu Gong, Jushun Yang, Jie Zhou, Jing Xiao, Jin-Hua Gu, Hong Yang, Jianfeng Zhu, Bosheng He
OBJECTIVE: Multislice computed tomography (MSCT) has been used for diagnosis of small intestinal diseases. However, the radiation dose is a big problem. This study was to investigate whether CARE Dose 4D combined with sinogram-affirmed iterative reconstruction (SAFIRE) can provide better image quality at a lower dose for imaging small intestinal diseases compared to MSCT. METHODS: The noise reduction ability of SAFIRE was assessed by scanning the plain water mold using SOMATOM Definition Flash double-source spiral CT...
December 3, 2018: Journal of Applied Clinical Medical Physics
Sunyoung Lee, Byong Duk Ye, Seong Ho Park, Kyung Jin Lee, Ah Young Kim, Jong Seok Lee, Hyun Jin Kim, Suk-Kyun Yang
Objective: To investigate the diagnostic yield of contrast-enhanced computed tomography (CT) in Crohn's disease (CD) patients presenting with acute severe lower gastrointestinal bleeding (LGIB), and the role of CT in predicting the risk of rebleeding. Materials and Methods: A consecutive series of 110 CD patients presenting with acute severe LGIB between 2005 and 2016 were analyzed. Among them, 86 patients who had undergone contrast-enhanced CT constituted the study cohort...
November 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Ashraf F Hefny, Adel Z Ayad, Nikolay Matev, Masoud O Bashir
INTRODUCTION: Psyllium in granular dosage form is used as an over - the counter safe laxative drug. It has a considerable hygroscopic propriety which allows it to retain water and expands rapidly to become many times of its original size. PRESENTATION OF THE CASE: 21-year-old man presented to the Emergency Department complaining of lower abdominal pain and constipation for five days. He was discharged home on Psyllium for treatment of the constipation. Two days later, he returned to the Emergency Department complaining of increased abdominal distension without passing any stools...
2018: International Journal of Surgery Case Reports
Isabelle De Kock, Louke Delrue, Clarisse Lecluyse, Pieter Hindryckx, Martine De Vos, Geert Villeirs
Background Assessment of Crohn's disease (CD) activity is important to identify patients with active inflammation for therapy management. Quantitative analysis can provide objective measurement of disease presence. Purpose To evaluate the feasibility of quantitative analysis of contrast-enhanced dual-energy computed tomography (DECT) data in detection of small bowel inflammation in patients with CD with an emphasis on iodine quantification. Material and Methods DECT enterography was prospectively performed in 20 patients with active CD and in 20 healthy individuals, as the control group...
September 5, 2018: Acta Radiologica
Jingyun Cheng, Hui Xie, Hao Yang, Ke Wang, Guobin Xu, Guangyao Wu
Objective: To explore the feasibility of computed tomography enterography (CTE) in the quantitative evaluation of the activity of Crohn's disease (CD). Methods: There were 49 CD patients with whole clinical, enteroscopy, and CTE data to be analyzed retrospectively. The patients were graded as inactive (0-2), mild (3-6), and moderate-severe group (>6) based on simplified endoscopic activity score for Crohn's disease (SES-CD). The differences in bowel wall thickening, mural hyperenhancement in the portal vein period, and the ΔCT values were analyzed among groups using ANOVA (analysis of variance) and q test...
2018: Gastroenterology Research and Practice
Trevor C Morrison, Michael Wells, Jeff L Fidler, Jorge A Soto
Lower gastrointestinal bleeding is defined as occurring distal to the ligament of Treitz and presents as hematochezia, melena, or with anemia and positive fecal occult blood test. Imaging plays a pivotal role in the localization and treatment of lower gastrointestinal bleeds. Imaging tests in the workup of acute lower gastrointestinal bleeding include computed tomography (CT) angiography, nuclear medicine scintigraphy, and conventional catheter angiography. Catheter angiography can also be used to deliver treatment...
September 2018: Radiologic Clinics of North America
Mark E Baker, Joel G Fletcher, Mahmoud Al-Hawary, David Bruining
Computed tomography enterography and magnetic resonance enterography are essential in the evaluation and treatment of patients with Crohn's disease. As such, examination reporting must use standardized nomenclature for effective communication. This report documents an interdisciplinary consensus of the Society of Abdominal Radiology, the Society of Pediatric Radiology, and the American Gastroenterology Association on the computed tomography enterography/magnetic resonance enterography imaging findings and imaging-based morphologic phenotypes...
September 2018: Radiologic Clinics of North America
Shannon P Sheedy, Amy B Kolbe, Joel G Fletcher, Jeff L Fidler
Computed tomography (CT) enterography is a noninvasive imaging modality with superb spatial and temporal resolution, specifically tailored to evaluate the small bowel. It has several advantages over other radiologic and optical imaging modalities, all of which serve as complementary investigations to one another. This article describes CTE technique, including dose reduction techniques, special considerations for the pediatric population, common technical and interpretive pitfalls, and reviews some of the more common small bowel entities seen with CTE...
September 2018: Radiologic Clinics of North America
Gene Kim, Jorge A Soto, Trevor Morrison
Gastrointestinal (GI) bleeding represents a broad differential of disease throughout the GI tract. The proper diagnostic evaluation of patients presenting with symptoms of GI bleeding depends on the overall clinical acuity and suspected source locations. The radiologic assessment of these patients is centered around computed tomography (CT) angiography, CT enterography, conventional angiography, and nuclear scintigraphy.
September 2018: Gastroenterology Clinics of North America
Seong Ho Park, Byong Duk Ye, Tae Young Lee, Joel G Fletcher
Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are presently state-of-the-art radiologic tests used to examine the small bowel for various indications. This article focuses on CTE and MRE for the evaluation of Crohn disease. The article describes recent efforts to achieve more standardized interpretation of CTE and MRE, summarizes recent research studies investigating the role and impact of CTE and MRE more directly for several different clinical and research issues beyond general diagnostic accuracy, and provides an update on progress in imaging techniques...
September 2018: Gastroenterology Clinics of North America
Narumi Taguchi, Seitaro Oda, Tateaki Kobayashi, Hideaki Naoe, Yutaka Sasaki, Masanori Imuta, Takeshi Nakaura, Yasuyuki Yamashita
We describe a case of small bowel Crohn's disease in which dual-energy computed tomography enterography using dual-layer spectral detector scanner contributed to quantitative assessment, and provided a higher degree of confidence pertaining to the diagnosis. Dual-layer spectral detector computed tomography enables retrospective analysis including virtual monochromatic imaging, iodine mapping, and determining the effective atomic number Z with routine scan protocols. These advanced parametric dual-energy imaging holds promising potential as an imaging biomarker for diagnosis, risk-stratification, monitoring of disease progression and therapy, and outcome prediction...
June 2018: Radiology Case Reports
Nan Zhuang, Qingli Zhu, Wenbo Li, Miaoqian Wang, Qian Yang, Wei Liu, Ji Li, Hong Yang, Weixun Zhou
RATIONALE: Primary lymphoma that arises from the intestine is an uncommon malignant tumour, while intestinal fistula caused by primary lymphoma is even rarer. Non-specific clinical performance makes early diagnosis difficult, although imaging modalities might play an essential role in the detection of intestinal fistula. PATIENT CONCERNS: Patient 1: A 60-year-old male hospitalized with diarrhoea and abdominal pain for seven months underwent computed tomography enterography (CTE) that demonstrated ileum internal fistula and ileac-sigmoid colon fistula...
July 2018: Medicine (Baltimore)
Michael L Wells, Stephanie L Hansel, David H Bruining, Joel G Fletcher, Adam T Froemming, John M Barlow, Jeff L Fidler
Acute gastrointestinal (GI) bleeding is common and necessitates rapid diagnosis and treatment. Bleeding can occur anywhere throughout the GI tract and may be caused by many types of disease. The variety of enteric diseases that cause bleeding and the tendency for bleeding to be intermittent may make it difficult to render a diagnosis. The workup of GI bleeding is frequently prolonged and expensive, with examinations commonly needing to be repeated. The use of computed tomography (CT) for evaluation of acute GI bleeding is gaining popularity because it can be used to rapidly diagnose active bleeding and nonbleeding bowel disease...
July 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Rui Feng, Kang Chao, Shu Ling Chen, Can Hui Sun, Yun Qiu, Bai Li Chen, Ren Mao, Yao He, Qing Hua Cao, Ling Xue, Zhi Rong Zeng, Sheng Hong Zhang, Min Hu Chen
OBJECTIVE: To investigate the role of heat shock protein family A member 6 (HSPA6) expression alone and in combination with clinical characteristics in distinguishing intestinal Behçet's disease (BD) from Crohn's disease (CD) with ileocolonic involvement. METHODS: Patients diagnosed with either intestinal BD or CD were enrolled. Their clinical characteristics, disease activity, laboratory test results including hypersensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR), endoscopic, pathological and radiological features were retrospectively analyzed...
June 2018: Journal of Digestive Diseases
Stephanie L Hansel, Jeffrey D McCurdy, John M Barlow, Jeff Fidler, Joel G Fletcher, Brenda Becker, Nayantara Coelho Prabhu, William A Faubion, Karen A Hanson, Sunanda V Kane, John B Kisiel, Edward V Loftus, Konstantinos A Papadakis, Darrell S Pardi, Laura E Raffals, Shayla Schoenoff, William J Tremaine, David H Bruining
Background: Ileocolonoscopy and computed tomography (CT) or magnetic resonance (MR) enterography (CTE/MRE) are utilized to evaluate patients with small bowel (SB) Crohn's disease (CD). The purpose of our study was to estimate the impact of capsule endoscopy (CE) on patient management after clinical assessment, ileocolonoscopy, and CTE/MRE. Methods: We prospectively analyzed 50 adult CD patients without strictures at clinically indicated ileocolonoscopy and CTE/MRE exams...
June 8, 2018: Inflammatory Bowel Diseases
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