Small-Bowel Imaging: Pitfalls in Computed Tomography Enterography/Enteroclysis

  • Marc J. Gollub


Computed tomography enterography (CTEG) is a focused CT scan examination of the small intestine that combines the advantages of isotropic, thin-section multiplanar CT; the large volumes of neutral-density oral contrast; and rapid administration of intravenous contrast. Oral contrast agents such as 0.1% barium, polyethylene glycol (PEG) and methylcellulose contain additives that inhibit fluid reabsorption and allow maximal bowel distention. Intravenous contrast is injected at the “enteric phase” (about 45 s) to provide maximum wall enhancement against the neutral-density lumen (0–30 HU) [1]. Pharmacological manipulation to interrupt small-bowel spasm and encourage gastric emptying is commonly used, including glucagon and metoclopramide, respectively. The indications for CTEG include Crohn’s disease and other enteritides, obscure gastrointestinal bleeding (OGIB), detection of intestinal masses, and sprue. A prospective blinded comparison of CTEG with wireless capsule endoscopy (WCE) using clinical consensus as the gold-standard found similar sensitivities (82 vs. 83%) for active small-bowel Crohn’s disease, but CTEG was far more specific than WCE (89 vs. 53%).


Bowel Distention Wireless Capsule Endoscopy Oral Contrast Agent Obscure Gastrointestinal Bleeding Compute Tomography Enterography 
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© Springer Verlag Italia 2010

Authors and Affiliations

  • Marc J. Gollub
    • 1
  1. 1.Memorial Sloan Kettering Cancer CenterNew YorkUSA

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