Skip to main content

Advertisement

SpringerLink
Log in

Multidetector CT in small-bowel neoplasms

La TC multidetettore nelle neoplasie dell’intestino tenue

  • Abdominal Radiology Radiologia Addominale
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to assess the diagnostic potential of multidetector computed tomography (MDCT) in the evaluation of small-bowel neoplasms.

Materials and methods

We studied 120 patients with suspected small-bowel disease by 16-slice MDCT after oral administration of a polyethylene glycol solution (n=56) or methylcellulose via a nasojejunal tube (n=64). Unenhanced and contrast-enhanced CT was performed. Contrast-enhanced CT images were acquired 40 s after IV injection of 130 ml of iodinated contrast agent at a rate of 3 ml/s. Multiplanar reconstructions were performed at the end of the examinations.

Results

Fifteen patients were found to be affected by small-bowel neoplasm (six had non-Hodgkin’s lymphoma, three had carcinoid tumour, two had Peutz-Jeghers syndrome, two had adenocarcinoma, two had melanoma metastases, one had lipoma). In the remaining patients, 58 cases of Crohn’s disease and seven miscellaneous diseases were detected. All findings were confirmed by barium studies, surgery or endoscopy.

Conclusions

MDCT performed after bowel-loop distension with low-density contrast material and IV administration of iodinated contrast agent is a reliable method for diagnosing and staging small-bowel neoplasms.

Riassunto

Obiettivo

Valutare le potenzialità diagnostiche della TC multidetettore nello studio delle neoplasie dell’intestino tenue.

Materiali e metodi

Sono stati studiati 120 pazienti con sospetta patologia tenuale mediante TC multidetettore (16 strati) previa somministrazione di polietilenglicole per via orale (n=56) o di metilcellulosa attraverso sondino naso-digiunale (n=64). L’esame TC è stato eseguito prima e durante infusione di 130 ml di MdC iodato con flusso di 3 ml/s ed inizio delle scansioni dopo 40 secondi dall’inizio della somministrazione. Al termine dell’esame sono state effettuate ricostruzioni multiplanari.

Risultati

Quindici pazienti sono risultati affetti da neoplasia dell’intestino tenue (6 pazienti con linfoma non Hodgking, 3 con carcinoide, 2 con sindrome di Peutz Jeghers, 2 con adenocarcinoma, 1 con metastasi da melanoma e 1 con lipoma). In 58 pazienti la diagnosi era di morbo di Crohn, in 7 pazienti erano presenti patologie varie. Tutti i quadri venivano confermati con studi baritati, intervento chirurgico o endoscopia.

Conclusioni

La TC multidetettore effettuata previa distensione delle anse con MdC ipodenso ed infusione ev di MdC iodato è una metodica utile nella diagnosi e stadiazione delle neoplasie tenuali.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References/Bibliografia

  1. Maglinte DDT, O’Connor K, Bessette J et al (1991) The role of physician in the late diagnosis of primary of the malignant tumors of the small intestine. Am J Gastroenterol 86:304–308

    PubMed  CAS  Google Scholar 

  2. Nolan DJ (2002) Barium studies. In: Gourtsoyiannis NC (ed) Radiological imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 59–72

    Google Scholar 

  3. Wilson SR (2002) Evaluation of the small intestine by ultrasonography. In: Gourtsoyiannis NC (ed) Radiological imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 73–85

    Google Scholar 

  4. Maglinte DD, Gourtsoyiannis N, Rex D et al (2003) Classification of small bowel Crohn’s subtypes based on multimodality imaging. Radiol Clin North Am 41:285–303

    Article  PubMed  Google Scholar 

  5. 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 28:106–116

    Article  PubMed  Google Scholar 

  6. Horton KM, Fishman EK (2003) The current status of multidetector row CT and three-dimensional imaging of the small bowel. Radiol Clin North Am 41:199–212

    Article  PubMed  Google Scholar 

  7. Di Mizio R, Rollandi GA, Bellomi M et al (2006) Multidetector-row helical CT enteroclysis. Radiol Med 111:1–10

    Article  Google Scholar 

  8. La Seta F, Buccellato A, Tesè L (2006) Multidetector-row CT enteroclysis: indications and clinical applications. Radiol Med 111:141–158

    Article  Google Scholar 

  9. Romano S, De Lutio E, Rollandi GA et al (2005) Multidetector computed tomography enteroclysis (MDCT-E) with neutral enteral and IV contrast enhancement in tumor detection. Eur Radiol 15:1178–1183

    Article  PubMed  Google Scholar 

  10. Boudiaf M, Jaff A, Soyer P et al (2004) Small bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients. Radiology 233:338–344

    Article  PubMed  Google Scholar 

  11. Orjollet-Lecoanet C, Mènard Y, Martins A et al (2000) CT enteroclysis for detection of small bowel tumors. J Radiol 81:618–627

    PubMed  CAS  Google Scholar 

  12. Pilleul F, Penigaud M, Milot L et al (2006) Possible small-bowel neoplasms: contrast-enhanced and water-enhanced Multidetector CT enteroclysis. Radiology 241:796–801

    Article  PubMed  Google Scholar 

  13. Feinstein AR (2002) Principles of medical statistics. Chapman and Hall, London

    Google Scholar 

  14. Bessette JR, Maglinte DDT, Kelvin FM et al (1989) Primary malignant tumors in the small bowel: a comparison of the small bowel enema and conventional follow-through examination. AJR Am J Roentgenol 153:741–744

    PubMed  CAS  Google Scholar 

  15. Ekberg O, Ekholm S (1980) Radiography in primary tumors of the small bowel. Acta Radiol Diagn 21:79–84

    CAS  Google Scholar 

  16. Hulnick DH, Megibow AJ, Balthazar EJ et al (1984) Computed tomography in the evaluation of diverticulitis. Radiology 152:491–495

    PubMed  CAS  Google Scholar 

  17. Herlinger H, Maglinte DDT (1989) Malabsorption and immune deficiencies. In: Herlinger H, Maglinte DDT (eds) Clinical radiology of the small intestine. WB Saunders Ed, Philadelphia, pp 349–398

    Google Scholar 

  18. Laurent F, Raynaud M, Biset JM et al (1991) Diagnosis and categorization of small bowel neoplasms: role of computed tomography. Gastrointest Radiol 16:115–119

    Article  PubMed  CAS  Google Scholar 

  19. Minordi LM, Vecchioli A, Guidi L (2006) Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease. Eur Radiol 16:1527–1536

    Article  PubMed  Google Scholar 

  20. Rollandi GA, Curone PF, Biscaldi E et al (1999) Spiral CT of the abdomen after distention of small bowel loops with transparent enema in patient with Crohn’s desease. Abdom Imaging 24:544–549

    Article  PubMed  CAS  Google Scholar 

  21. Balthazar EJ (1991) CT of the gastrointestinal tract: principles and interpretation. AJR Am J Roentgenol 156:23–32

    PubMed  CAS  Google Scholar 

  22. Desai RK, Tagliabue JR, Wegryn SA et al (1991) CT evaluation of wall thickening in the alimentary tract. Radiographics 11:771–783

    PubMed  CAS  Google Scholar 

  23. Gore RM, Balthazar EJ, Ghahremani GG et al (1996) CT features of ulcerative colitis and Crohn’s disease. AJR Am J Roentgenol 167:3–15

    PubMed  CAS  Google Scholar 

  24. Levine MS, Drooz AT, Herlinger H (1987) Anular malignancies of the small bowel. Gastrointest Radiol 12:53–58

    Article  PubMed  CAS  Google Scholar 

  25. Gossios KJ, Tsianos EV (1997) Crohn disease: CT findings after treatment. Abdom Imag 22:160–163

    Article  CAS  Google Scholar 

  26. Mazzeo S, Caramella D, Belcari A et al (2005) Multidetector CT of the small bowel: evaluation after oral hyperhydration with isotonic solution. Radiol Med 109:516–526

    Google Scholar 

  27. Wold PB, Fletcher JG, Johnson CD et al (2003) Assessment of small bowel Crohn disease: non invasive peroral CT enterography compared with other imaging methods and endoscopy-feasibility study. Radiology 229:275–281

    Article  PubMed  Google Scholar 

  28. Makò EK, Mester AR, Tarjan Z et al (2000) Enteroclysis and spiral CT examination in diagnosis and evaluation of small bowel Crohn’s disease. Eur J Radiol 35:168–175

    Article  PubMed  Google Scholar 

  29. Raptopoulos V, Schwartz RK, McNicholas MM et al (1997) Multiplanar helical CT enterography in patients with Crohn’s disease. AJR Am J Roentgenol 169:1545–1550

    PubMed  CAS  Google Scholar 

  30. Bender GN, Maglinte DD, Kloppel VR et al (1999) CT enteroclysis: a superfluous diagnostic procedure or valuable when investigating small bowel disease? AJR Am J Roentgenol 172:373–378

    PubMed  CAS  Google Scholar 

  31. Turetschek K, Schober E, Wunderbaldinger P et al (2002) Findings at helical CT-enteroclysis in symptomatic patients with Crohn disease: correlation with endoscopic and surgical findings. J Comput Assist Tomogr 26:448–492

    Article  Google Scholar 

  32. Megibow AJ, Babb JS, Hecht EM et al (2006) Evaluation of bowel distention and bowel wall appearance by using neutral oral contrast agent for multi-detector row CT. Radiology 238:87–95

    Article  PubMed  Google Scholar 

  33. Laghi A, Passariello R (2003) Magnetic resonance in the study of the small bowel. Radiol Med 106:1–15

    Google Scholar 

  34. Magnano G, Granata C, Barabino A et al (2003) Polyethylene glycol and contrast-enhanced MRI of Crohn’s disease in children: preliminary experience. Pediatr Radiol 33:385–391

    PubMed  Google Scholar 

  35. Balthazar EJ (2002) Evaluation of the small intestine by computed tomography. In: Gourtsoyiannis NC (ed) Radiological imaging of the small intestine. Springer, Berlin Heidelberg New York, pp 87–130

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Bioimmagini e Scienze Radiologiche, Istituto di Radiologia, UCSC, L.go A. Gemelli 8, I-00168, Roma, Italy

    L. M. Minordi, A. Vecchioli, P. Mirk, E. Filigrana, G. Poloni & L. Bonomo

Authors
  1. L. M. Minordi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Vecchioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Mirk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Filigrana
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Poloni
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Bonomo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. M. Minordi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Minordi, L.M., Vecchioli, A., Mirk, P. et al. Multidetector CT in small-bowel neoplasms. Radiol med 112, 1013–1025 (2007). https://doi.org/10.1007/s11547-007-0202-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-007-0202-0

Key words

Parole chiave

Search

Navigation