European Radiology

, Volume 15, Issue 6, pp 1178–1183 | Cite as

Multidetector computed tomography enteroclysis (MDCT-E) with neutral enteral and IV contrast enhancement in tumor detection

  • Stefania Romano
  • Elisabetta De Lutio
  • Gian Andrea Rollandi
  • Luigia Romano
  • Roberto Grassi
  • Dean D. T. Maglinte


The aim of our study was to evaluate the reliability of MDCT-enteroclysis (MDCT-E), an emerging technique of small bowel examination that combines the advantages of MDCT examination of the abdomen and the enteral volume challenge of enteroclysis, in evaluation of small bowel neoplasms. In our institutions, MDCT-E was used to study 456 patients (age range 21–84 years, mean 53 years) admitted for suspicion of small bowel disease. All examinations were done on multichannel CT units, 129 on a 16-slice scanner and 327 on a four-slice scanner. Post-processing and multiplanar reformatting and interpretation were performed on dedicated workstations. After adequate gastrointestinal preparation and naso-enteric intubation, small bowel was distended by methylcellulose infused by a peristaltic pump. One volumetric MDCT acquisition was obtained after 120–130 ml of intravenous contrast medium. Multiplanar reformatting was based on the image reconstruction parameters from 3 to 4 mm. Forty-five small bowel neoplasms were found; in the remaining cases, 223 Crohn’s diseases and 149 other abnormalities were detected. All findings were confirmed by surgery, endoscopy or clinical follow-up. In our experience, MDCT-E with neutral enteral and IV contrast seems to be a reliable method in the diagnosis of small bowel neoplasms.


MDCT Enteroclysis Small bowel tumor CT, intestines Intestines, disease 


  1. 1.
    Gourtsoyannis N, Makò E (1997) Imaging of primary small intestinal tumors by enteroclysis and CT with pathological correlations. Eur Radiol 7:625–642Google Scholar
  2. 2.
    Good CA (1963) Tumors of the small intestine. Am J Roentgenol 89:685–705Google Scholar
  3. 3.
    Maglinte DDT, Herlinger H (1999) Small bowel neoplasms In: Herlinger H, Maglinte DDT, Birnbaum BA (eds) Clinical imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 377–438Google Scholar
  4. 4.
    Maglinte DDT, O’Connor K, Bessette J, Chernish SM, Kelvin FM (1991) The role of the physician in the late diagnosis of primary malignant tumors of the small intestine. Am J Gastroenterol 86:304–308Google Scholar
  5. 5.
    Zollinger RM Jr (1986) Primary neoplasms of the small intestine. Am J Surg 151:654–658Google Scholar
  6. 6.
    Yang YS, Huang QY, Wang WF, Sun G, Peng LH (2003) Primary jejunoileal neoplasmas: a review of 60 cases. World J Gastroenterol 9(4):862–864Google Scholar
  7. 7.
    Bessette JR, Maglinte DDT, Kelvin FM, Gernish SM (1989) Primary malignant tumors in the small bowel: a comparison of the small bowel enema and conventional follow-through examination. Am J Roentgenol 153:741–744Google Scholar
  8. 8.
    Gourtsoyannis N, Bays D, Malamas M, Barouxis G, Liasis N (1992) Radiological appearances of small intestinal leiomyomas. Clin Radiol 45:94–103Google Scholar
  9. 9.
    Horton KM, Fishman EK (2004) Multidetector-row computed tomography and 3-dimensional computed tomography imaging of small bowel neoplasms: current concept in diagnosis. J Comput Assist Tomogr 28(1):106–116Google Scholar
  10. 10.
    Horton KM, Fishman EK (2003). The current status of multidetector row CT and three-dimensional imaging of the small bowel. Radiol Clin N Am 41(2):199–212Google Scholar
  11. 11.
    Orjollet-Lecoanet C, Ménard Y, Martins A, Crombé- Ternamian A, Cotton F, Valette PJ (2000) L’entéroscanner: une nouvelle méthode d’exploration du grele. J Radiol 81:618–627PubMedGoogle Scholar
  12. 12.
    Voderholzer WA, Ortner N, Rogalla P, Beinholzl J, Lochs H (2003) Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis. Endoscopy 35(12):1009–1014Google Scholar
  13. 13.
    Bender GN, Maglinte DDT, Von Kloppel R, Timmons JH (1999) CT enteroclysis: a superfluous diagnostic procedure or valuable when investigating small-bowel disease? Am J Roentgenol 172:373–378Google Scholar
  14. 14.
    Grassi R, Di Mizio R, Romano S, Cappabianca S, Del Vecchio W, Severini S (2000) Multiple jejeunal angiodysplasia detected by enema-helical CT. Clin Imag 24(2):61–63CrossRefPubMedGoogle Scholar
  15. 15.
    Rollandi GA, Curone PF, Biscaldi E, Nardi F, Bonifacino E, Conzi R, Derchi LE (1999) Spiral CT of the abdomen after distention of small bowel loops with transparent enema in patients with Crohn’s disease. Abdom Imaging 24(6):544–549Google Scholar
  16. 16.
    Rollandi GA, Biscaldi E (2000) CT enteroclysis. In: Terrier F, Grosholtz, Becker CD (eds) Spiral CT of the abdomen. Springer, Berlin Heidelberg New York, pp 369–383Google Scholar
  17. 17.
    Maglinte DDT, Bender GN, Heitcamp DE, Lappas JK, Kelvin FM (2003) Multidetector-row helical CT enteroclysis. Radiol Clin N Am 41(2):249–262Google Scholar
  18. 18.
    Bruel JM, Gallix B (2003) Multidetector CT and MR in diseases of the gastrointestinal tract. J Radiol 84:499–513PubMedGoogle Scholar
  19. 19.
    Schmidt S, Lepori D, Mewly JY, Duvoisin B, Meuli R, Michetti P et al (2003) Prospective comparison of MR enteroclysis with multidetector spiral-CT enteroclysis: interobserver agreement and sensitivity by means of “sign-by-sign” correlation. Eur Radiol 13:1303–1311Google Scholar
  20. 20.
    Boudiaf M, Jaff A, Soyer P, Bouhnik Y, Hamzi L, Rymer R (2004) Small bowel disease: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients. Radiology 233:338–344Google Scholar
  21. 21.
    Fleishmann D (2003) Future prospects in MDCT imaging. Eur Radiol 13:M127–M128Google Scholar
  22. 22.
    Verdun FR, Noel A, Meuli R, Pachoud M, Monnin P, Valley JF et al (2004) Influence of detector collimation on SNR in four different MDCT scanners using a reconstructed slice thickness of 5 mm. Eur Radiol 14:1866–1872Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Stefania Romano
    • 1
  • Elisabetta De Lutio
    • 1
  • Gian Andrea Rollandi
    • 2
  • Luigia Romano
    • 1
  • Roberto Grassi
    • 3
  • Dean D. T. Maglinte
    • 4
  1. 1.Department of Diagnostic ImagingA.Cardarelli HospitalNaplesItaly
  2. 2.2nd Service of RadiologySan Martino HospitalGenovaItaly
  3. 3.Institute of RadiologySecond University of NaplesNaplesItaly
  4. 4.Department of RadiologyIndiana University School of MedicineIndianapolisUSA

Personalised recommendations