Role of multidetector computed tomography enterography in the evaluation of small bowel diseases

Abstract

Background: Small bowel imaging is technically challenging due to the difficulty in displaying the long and serpentine small bowel in entirety and intrinsic motion peristalsis and positional changes caused by breathing. Multidetector computed tomography (MDCT) enterography with the use of neutral enteric contrast permits an excellent assessment of the small bowel pathologies. Objective: The objective of this study is to determine the radiological features of small bowel diseases with respect to the presence, localization, causes, and associated complications with MDCT enterography. Materials and Methods: This is a single-center, cross-sectional, analytical study, which was carried over a period of 2 years on 43 patients, in a medical institute at department of radiodiagnosis. The study was conducted with Philips Brilliance 64-Slice computed tomography machine with neutral enteric contrast and intravenous contrast agents with arterial and enteric or portal phases. Imaging findings were correlated clinically, surgically, and histopathologically. Results: Out of the 43 cases, nine cases (20.93%) were of malignant pathologies, 20 cases were of nonmalignant mural pathologies (46.51%), and 14 cases were other intraluminal or extraluminal pathologies. The common bowel wall patterns found in nonneoplastic pathologies were segmental (50%), symmetrical (70%), mild-to-moderate wall thickening (70%), homogeneous and stratified attenuation patterns (95%), whereas segmental (80%), asymmetrical (80%), marked wall thickening (100%), and heterogeneous enhancement patterns (60%) with distal bowel involvement in primary malignancy cases. Mean wall thickness in malignant pathologies (21.56 ± 15.68 mm) was statistically significantly higher than mean wall thickness of nonmalignant pathologies (7.85 ± 3.69 mm) with P value of 0.031 (<0.05). Conclusion: MDCT enterography is a powerful diagnostic tool for the study of small bowel disorders, including inflammatory disease, small bowel neoplasms, and mechanical obstruction.