methylcellulose and iopromide

This study was done to evaluate the diagnostic role of enteroclysis with multidetector computed tomography (MDCT) and single-detector CT (SDCT) in patients affected by small-bowel Crohn's disease.. Forty-five patients underwent abdominal SDCT (n=20) or 16-row MDCT (n=25) after administration of methylcellulose by nasojejunal tube. Each examination was assessed for small-bowel distension and site and characteristics of the diseased loops. The two CT techniques were then compared. Results were compared with double-contrast enteroclysis performed in all patients and with ileoscopy performed in 28 patients.. In comparison with double-contrast enteroclysis, sensitivity, specificity and diagnostic accuracy were 90%, 71% and 89% for SDCT and 92%, 83% and 90% for MDCT. Ileoscopy confirmed the absence of disease in five patients and the presence of Crohn's disease in 20. Compared with SDCT, MDCT reduced scanning time and respiratory artefacts and permitted better multiplanar reconstructions.. MDCT is superior to SDCT because it allows a better spatial resolution and improves depiction of the pathological patterns of Crohn's disease.

Topics: Adult; Aged; Chi-Square Distribution; Contrast Media; Crohn Disease; Female; Humans; Intestine, Small; Iohexol; Male; Methylcellulose; Middle Aged; Prospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed

Aim of the study was to compare the visualisation of small bowel tumours particularly lymphoma of the small bowel by enteroclysma, computed tomography (CT) and computed tomography following enteroclysma.. We examined 97 examinations in 63 patients. Non Hodgkin's Lymphoma was the primary malignancy in 44 patients, metastasis of different malignancies in 8 patients, primary malignancies of the small intestine in 5 patients, mesenteric tumours in 4 patients and postoperative stricture in another 2 patients. CT following enteroclysma (CT Sellink) was performed as helical CT in 55 patients and as incremental CT in 42 patients. Examinations were evaluated by two radiologists. Evaluation criteria were small bowel distension, perceptibility of details and topographic correlation.. Manifestations of lymphoma were found in 32 patients, infiltration of bowel wall in 12 patients. In three patients metastases of melanoma were found. In three patients the suspicion for small bowel tumours was not verified in CT Sellink. The perceptibility of details was evaluated as ameliorated in 45.5% of examinations over all.. CT Sellink offers remarkable advantages in the diagnosis of small bowel tumours compared with enteroclysma and "conventional" computed tomography under intra-venous and oral contrast media. CT Sellink was feasible over a time of 7 years now in clinical praxis. This examination represents an optimized standard in small intestine examination.

Topics: Adult; Aged; Contrast Media; Female; Humans; Image Processing, Computer-Assisted; Intestinal Neoplasms; Intestine, Small; Iohexol; Lymphoma, Non-Hodgkin; Male; Methylcellulose; Middle Aged; Radiographic Image Enhancement; Sensitivity and Specificity; Tomography, X-Ray Computed

Spiral computer tomography (SCT) became an important supplement to the Sellink examination. Multi slice computer tomography (MSCT) achieves a z-axis resolution of 1-2 mm without considerable increase in the acquisition time. In this paper, examination technique in first clinical results of CT-Sellink examination with MSCT, including the 3D-reconstruction are presented.. The investigations were carried out with the Somatom Plus 4 Volume Zoom (Siemens, Forchheim) scanner. The following parameters were employed: 4 parallel detector ledges, collimation 4 x 1 mm, tube power 140 mA, tube voltage 120 kV, pitch 5 up to 6 mm, slice thickness 1 mm and 2 mm, reconstruction with 50% overlap. Via a duodenal tube, the small intestine was distended by means of 1.5 up to 2.5 l methyl-cellulose suspension. The data were acquired 35 s after injection of 120 ml contrast media (Ultravist). Various methods of postprocessing were applied on a workstation.. As of yet, 16 patients were examined with MSCT-Sellink. In 4 cases pathological findings were detected with MSCT-Sellink, which were not recognized with X-ray Sellink.. Due to high z-axis resolution and short acquisition time, the morphological details of the small intestine can be visualized utilizing MSCT-Sellink. The data set is well suited for 3D postprocessing. Improvement of diagnostic accuracy can be anticipated.

Topics: Adult; Aged; Contrast Media; Humans; Image Processing, Computer-Assisted; Intestinal Obstruction; Intestine, Small; Iohexol; Methylcellulose; Middle Aged; Tomography, X-Ray Computed