Multidetector CT (MDCT), over the past decade, has become the primary imaging modality for evaluating gastrointestinal tract disorders, particularly in the small bowel. MDCT offers panoramic and high-resolution images, it is widespread available and the technique is robust, reproducible and accurate. Careful patient preparation is required, because of the need for bowel distension, achievable through the use of an enteral contrast agent (neutral or positive) delivered either orally (MDCT-enterography) or through a naso-jejunal tube (MDCT-enteroclysis). Scanning protocol is fast and thanks to new devices (automatic dose modulator systems) and/or new image reconstruction methods (iterative algorithms) able to deliver a very low amount of radiation, especially important when imaging young individuals. The most common clinical indication is represented by the evaluation of patients with Inflammatory Bowel Disease, both at the time of the diagnosis and in follow-up, where MDCT is able to provide an accurate balance of the disease: extent of the bowel involvement, assessment of disease activity and potential complications. The detection of small bowel tumours is another important indication where MDCT represents, in some cases, the only method to investigate small bowel loops and in any case the best method for staging neoplastic lesions. An additional reason to perform MDCT of the small bowel is the evaluation of malabsorption syndromes.
KeywordsInflammatory Bowel Disease Small Bowel Celiac Disease Bowel Wall Lean Body Weight
- Kelvin FM, Herlinger H (1999) Crohn’s disease. In: Herlinger H, Maglinte DDT, Birnbaum BA (eds) Clinical imaging of the small intestine. Springer, Berlin, pp 259–289Google Scholar
- Mako EK, Mester AR et al (2000) Enteroclysis and spiral CT examination in diagnosis and evaluation of small bowel Crohn’s disease. Eur J Radiol 35:168–175Google Scholar
- Patak MA, Mortele KJ, Ros PR (2005). Multidetector row CT of the small bowel. Radiol Clin North Am 43:1063–1077Google Scholar